Related Experiment Videos
Effect of nebulized ipratropium bromide on intraocular pressures in children
W T Watson1, E P Shuckett, A B Becker
1Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.
Insights
Nebulized ipratropium bromide is safe for children with asthma, showing no adverse effects on intraocular pressure or pupil response. This study confirms minimal risk even with inadvertent eye exposure during asthma treatment.
Area of Science:
- Ophthalmology
- Pediatric Pulmonology
- Clinical Pharmacology
Background:
- Asthma management in children often involves inhaled medications.
- Concerns exist regarding potential ocular side effects of nebulized ipratropium bromide due to proximity of administration to the eyes.
Purpose of the Study:
- To assess the impact of nebulized ipratropium bromide on intraocular pressures (IOP) and pupillary responses in pediatric asthma patients.
- To determine the safety profile of this asthma medication concerning ocular parameters.
Main Methods:
- A double-blind, randomized, crossover study involving children aged 6-17 with asthma.
- Participants received nebulized ipratropium bromide with albuterol, albuterol alone, or saline via face mask.
- Intraocular pressures, pupillary size, and responses were measured pre- and post-nebulization. An open-label follow-up study was also conducted.
Main Results:
- No statistically significant changes in intraocular pressures were observed after any treatment.
- Pupillary size and pupillary responses remained unaffected throughout the study.
- Results were consistent across both the double-blind and open-label study phases.
Conclusions:
- Nebulized ipratropium bromide, when administered via face mask to children with asthma and no prior ocular issues, poses an extremely low risk of adverse ocular reactions.
- The findings support the safety of using nebulized ipratropium bromide in pediatric asthma care regarding ocular health.
Study Objective:
To evaluate the effects of nebulized ipratropium bromide on intraocular pressures and pupillary responses in children with asthma.
Design:
A double-blind, randomized, crossover study.
Setting:
Children's Hospital of Winnipeg, University of Manitoba.
Patients Or Participants:
Age 6 to 17 years with asthma.
Intervention:
Nebulized ipratropium bromide added to albuterol sulfate, albuterol alone, or saline solution was given by face mask and nebulizer. Before and 0.5 h after nebulization, intraocular pressures (mm Hg), pupillary size (mm), and pupillary responses were measured. In a subsequent open study, patients who had been admitted to hospital with acute asthma who were treated with nebulized ipratropium bromide were recruited for measurement of intraocular pressures, pupillary size, and pupillary responses.
Measurements And Results:
Twenty patients completed the double-blind study, and 26 patients completed the open study. There were no changes in intraocular pressures, pupillary size, or pupillary response after any treatment on any study day in either the double-blind or the open studies.
Conclusion:
In children with asthma, who have no pre-existing ocular abnormalities, the risk of an adverse reaction to nebulized ipratropium bromide delivered by face mask inadvertently absorbed in the eye is extremely small.