Allergic rhinitis ipratropium

Ipratropium bromide (Atrovent) nasal spray is an anticholinergic agent useful in perennial allergic rhinitis. 

For symptomatic relief of rhinorrhea associated with seasonal allergic rhinitis-The recommended dose of ipratropium bromide 0.06% nasal spray is 2 sprays (84 meg) per nostril 4 times daily (total dose 672 meg/day) in adults and children 5 years of age and older. 

The safety and efficacy of the use of ipratropium bromide 0.06% nasal spray beyond 3 weeks in patients with seasonal allergic rhinitis have not been established. 

Antihistamines and intranasal corticosteroids are the first-line treatments for allergic rhinitis. Sodium cromoglicate, ipratropium bromide and decongestants, are alternative or add-on treatments. Drug treatment should be selected according to the severity, frequency and duration of symptoms ... 

A nasal spray (isotonic aqueous ipratropium pump) has been used in allergic and non-allergic rhinitis as well as the common cold. The spray caused no systemic adverse effects and only minor infrequent episodes of nasal dryness and epistaxis, which did not interfere with treatment (15,16). 

Cromolyn sodium and ipratropium bromide offer two additional approaches for treating allergic rhinitis. Cromolyn sodium is a mast cell stabilizer. Increased interest in this product has resulted from it becoming available without a prescription. Ipratropium bromide is an anticholinergic agent useful in pereimial allergic rhinitis. 

Intranasal anticholinergics effectively reduce rhinorrhea. Ipratropium bromide, oxitropium bromide, tiotpropium bromide, and glycopyrrolate are quaternary structured ammonium muscarinic receptor antagonists, which are poorly absorbed into the systemic circulation. They reduce nasal secretions by influence on submucosal glands innervated by parasympathetic nerves (74). Intranasal anticholinergics are ineffective for control of allergic rhinitis symptoms other than rhinorrhea (74). 

Ipratropium nasal spray is an anticholinergic agent that exhibits antisecretory properties when applied locally. It provides symptomatic relief of rhinorrhea associated with allergic and other forms of chronic rhinitis. The 0.03% solution is given as two sprays (42 meg) two to three times daily. The optimal dose should be determined based on the specific patient s symptoms and response. Adverse effects are mild, with the most common being headache, nosebleeds, and nasal dryness. 

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