Combivent Vials

Combivent contains albuterol sulfate and ipratropium bromide. It is both a beta2-adrenergic bronchodilator and an anticholinergic bronchodilator. Patients with lung disease, emphysema, bronchitis, and chronic obstructive pulmonary disease (COPD) are prescribed Combivent to treat and prevent wheezing and breathlessness.

Mode of action

The anticholinergic (parasympatholytic) property of ipratropium bromide is a result of its quaternary ammonium composition. There has been some evidence that it inhibits vagal reflexes by inhibiting acetylcholine release from the vagus nerve. In the bronchial smooth muscle, acetylcholine interacts with muscarinic receptors to increase intracellular Ca++ concentration. An anticholinergic inhibits this reaction.

Diacylglycerol (DAG) is a second messenger that induces Ca++ release via inositol triphosphate (IP3). As a result of inhaling ipratropium bromide, bronchodilation is primarily localized to the lung.

A beta-adrenergic agent, salbutamol sulfate, acts on airway smooth muscle to relax it. By relaxing all smooth muscles, salbutamol protects against all threats to bronchoconstriction.

The simultaneous use of ipratropium bromide and salbutamol sulfate in this medication produces bronchodilation not experienced with either drug alone.

Method of administration

Medical supervision is recommended when using the treatment, such as in the hospital setting. In exceptional cases, home-based treatment may be recommended.

Combivent may only be administered using an intermittent positive pressure ventilator or by nebulizer. The dose units must never be swallowed or injected.

When using a nebulized solution, the lowest recommended dose should always be used. A second unit dose vial may be necessary in extremely severe cases. When symptoms are sufficiently relieved, treatment should be discontinued.

Nebulization does not require dilution of the contents of unit dose vials.

Make sure to follow the manufacturer or physician's instructions when preparing the nebulizer to be filled.

• Remove one unit dose by tearing the pouch foil
• Twist the top of the vial firmly to open it
• Fill the nebulizer reservoir with the contents of the unit dose vial
• Nebulizers should be assembled and used according to instructions
• If any solution remains in the reservoir after use, remove it and follow the manufacturer's instructions to clean the nebulizer

For safety against microbial contamination, it is essential to use the vial contents within 48 hours of opening it. Patients should ensure to use a new vial each time.

Dosage:

Patients older than 12 years and elderly patients:

Three or four single-dose units per day.

Combivent side effects

• Dizziness
• Headache
• Dry mouth
• Nausea
• Nervousness
• Shaking or rumors
• Cold symptoms such as sore throat

Alternatives

Spiriva: This medication is prescribed for the management of COPD. There are also other uses for Spriviva.

Advair Diskus: This medication is prescribed for asthma and COPD maintenance. There may be other uses for Advair as well.

Contraindications

• Patients with tachyarrhythmia or HOC--hypertrophic obstructive cardiomyopathy
• Anyone who has ever experienced sensitivity to atropine and its derivatives

Precautions

In rare cases, urticaria, rash, angioedema, and bronchospasm have occurred after the administration of Combivent.

Combining Combivent with certain medicines may cause paradoxical bronchospasms. A substitute therapy should be employed in the event of paradoxical bronchospasm caused by Combivent.

When the medication has touched the eyes, there have been isolated cases of increased intraocular pressure,  mydriasis, eye pain, and narrow-angle glaucoma.

It is important not to let the solution or mist get into the eyes. Glaucoma patients should specifically take precautions to protect their eyes.

In a nebulizer containing Combivent, adding other drugs is strongly discouraged.

Interactions

Anticholinergic medications should not be taken in conjunction with Combivent.

The side effects due to concomitantly administering xanthine derivatives and beta-adrenergics or anticholinergics may be greater.

Hypokalaemia caused by beta2 agonists may be aggravated by concomitant administration of diuretics, glucocorticoids, and xanthine derivatives.

Hypokalemia can increase the risk of arrhythmias in people taking digoxin. This is a situation where serum potassium levels need to be monitored.

It has been suggested that the cardiovascular effects of beta-agonists may be exacerbated by the use of halogenated hydrocarbon anesthetics enflurane, halothane, and trichlorethylene.

Combivent and numerous prescription and nonprescription medications can be purchased on Kiwi Drug at affordable rates. Licensed pharmacists and physicians are on standby to help customers with a treatment plan or prescription refill. Worldwide shipping is available on all orders.