Medication 7-296 - Duoneb (Ipratropium and Albuterol, Combivent)

CMH EMS & MIH Protocols

Scope of Practice:

• Advanced Emergency Medical Technician
• Registered Nurse
• Paramedic
• Community Paramedic

Route(s):

• Neb,

Pharmacodynamics (class and mechanism of action):

• Anticholinergic (Beta adrenergic. Binds and stimulates beta-2 receptors, resulting in relaxation of bronchial smooth muscle. Antagonizes the acetylcholine receptor, producing bronchodilation.).

Pharmacokinetics:

• Half-life: 1.6-2 hours.
• Onset time: 5-15 minutes.
• Peak action time: 0.5-2 hours.
• Duration of action: 2-6 hours.

• Peak	24	48	72	96	120	144	168	192	216	240	264	minutes
  Duration	24	48	72	96	120	144	168	192	216	240	264	minutes

Dosing:

• Refer to specific protocol(s) below for dose(s).

Indications:

• Protocol 2-770 - Respiratory Distress.

Contraindications:

• Hypersensitivity to Ipratropium, Albuterol, or Atropine.
• Allergy to soybeans or peanuts.
• Closed angle glaucoma.
• Bladder neck obstruction.
• Prostatic hypertrophy.

Pregnancy Risk Factor:

• Category C
• Risk not ruled out: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. FDA requires a relatively large amount of high-quality data on a pharmaceutical for it to be defined as Pregnancy Category A. As a result of this, many drugs that would be considered Pregnancy Category A in other countries are allocated to Category C by the FDA.

Potential Incompatibilities:

• NA.

Precautions and Adverse Effects:

• Use caution in patients with known heart disease.
• Blood pressure, pulse, and ECG should be monitored.
• May cause paradoxical acute bronchospasm, palpitations, anxiety, headache, dizziness, sweating, Tachycardia, cough, Nausea, arrhythmias, paradoxical acute Bronchospasm.

Antidote:

• Physostigmine.

Controlled Substance Information:

• Not a scheduled drug
• The DEA and FDA have not identified this drug with a schedule classification.
• DEA number: NA.
• Narcotic: No.
• Street names: NA.

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Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.