Hemodynamic and non-bronchial effects of ipratropium bromide

Older anticholinergic agents such as stramonium and atropine have significant non-pulmonary effects. The non-pulmonary effects of a new quaternary anticholinergic, ipratropium bromide, have been studied both in the United States and abroad; these effects include inhibition of salivation, interference with micturition, and ocular effects such as pupil size, visual acuity, and intraocular pressure. Hemodynamic effects such as heart rate, blood pressure, and blood gas changes have also been studied. These evaluations have been performed in animals and in healthy and sick human subjects, following administration of ipratropium parenterally and by inhalation in a variety of dosage ranges. Ipratropium, a muscarinic inhibitor, would be expected to have effects similar to those of atropine. The most conspicuous result of these studies has been the low incidence of significant changes, even at high dose levels, when ipratropium bromide is administered by inhalation.