A provider has prescribed ipratropium bromide/albuterol sulfate ...

[Mimi]

A provider has prescribed ipratropium bromide/albuterol sulfate (Combivent) for a patient who has chronic obstructive pulmonary disease (COPD). The nurse explains that this combination product is prescribed primarily for which reason?
 
  a. To be more convenient for patients who require both medications
  b. To improve compliance in patients who may forget to take both drugs
  c. To increase forced expiratory volume, an indicator of symptom improvement
  d. To minimize the side effects that would occur if the drugs are given separately

Question 2

A patient will begin using ipratropium bromide (Atrovent), albuterol (Proventil), and an inhaled glucocorticoid medication (steroid) to treat chronic bronchitis.
 
  When teaching this patient about disease and medication management, the nurse will instruct the patient to administer these medications in which order?
  a. Albuterol, ipratropium bromide, steroid
  b. Albuterol, steroid, ipratropium bromide
  c. Ipratropium bromide, albuterol, steroid
  d. Steroid, ipratropium bromide, albuterol

[apple]

Answer to Question 1

ANS: C
Combivent is more effective and has a longer duration of action than if either agent is used alone, and the two agents combined increase the FEV1. While it is more convenient and may improve compliance, this is not the primary reason for using it. The combination does not alter drug side effects.

Answer to Question 2

ANS: A
Patients who use a beta agonist should be taught to use it 5 minutes before administering ipratropium bromide, and ipratropium bromide should be given 5 minutes prior to an inhaled glucocorticoid. This helps the bronchioles to dilate so the subsequent medication can be deposited in the bronchioles for improved effect.

[Mimi]

TY

[apple]

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