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How do Ipratropium and Albuterol Inhalers Work?

By H. Colledge
Updated May 17, 2024
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Ipratropium and albuterol are both drugs which widen the airways, or bronchi, which aids breathing difficulties. Drugs which act in this way are commonly known as bronchodilators, and there are a number of different types. Albuterol is an example of what is called a beta-adrenergic agonist, which stimulates receptors in bronchial wall muscles causing the respiratory passages to relax and widen. Ipratropium is an anticholinergic drug, which prevents a substance called acetylcholine from binding to receptors in the bronchial wall muscles. Since acetylcholine would normally cause the airways to constrict and produce mucus, the action of ipratropium serves to dilate the respiratory passages and keep them clear.

Beta agonist drugs such as albuterol, also known as salbutamol, are often used in the treatment of asthma. As asthma drugs, they are usually inhaled, which has the advantage that the medication passes directly to the muscles in the respiratory passages, acting more quickly than a tablet, which would have to be absorbed from the gut into the bloodstream before it could have an effect. Using asthma inhalers also reduces side effects, such as a fast heartbeat or shaking, caused by the drugs having effects on receptors in other parts of the body, apart from the airways. Such asthma treatments may be used to prevent attacks as well as treat them.

Although ipratropium and albuterol are different types of drug, and ipratropium is not commonly used to treat asthma, it is also available in an inhalable form, providing similar advantages of rapid action and reduced side effects. An inhaler which combines ipratropium and albuterol is used to treat chronic obstructive pulmonary disease, or COPD. COPD is the name for a group of conditions which includes emphysema and chronic bronchitis. For the treatment of COPD, it is thought that taking a combination of these drugs is more effective than using either of the drugs alone. In more severe forms of COPD, ipratropium and albuterol may be inhaled using what is known as a nebulizer, a device which converts the drugs into a mist which is breathed in through a mask.

While both ipratropium and albuterol cause bronchial muscle relaxation and airway widening, an anticholinergic drug such as ipratropium takes longer to have an effect, and its action is weaker compared with a beta-adrenergic agonist drug like albuterol. For this reason, anticholinergic bronchodilators are not commonly used in the treatment of asthma, where quicker, more powerful airway widening is generally required. In the emergency treatment of severe asthma, before the patient reaches the hospital, both drugs are sometimes administered together.

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Discussion Comments

By candyquilt — On Dec 28, 2014

@ysmina-- That's because ipatroium and albuterol affect different receptors in the lungs. So even though they eventually do the same thing, they do it in different ways. The combined inhaler is therefore prescribed in some conditions because the combination works much better than any one of the medications alone.

So it's used for bronchitis, which is why you need it and also for emphysema. Albuterol relaxes the smooth muscle cells in the airways. Ipratropium also relaxes airway muscles but it does it by limiting the interaction between nerves that cause these muscles to contract. If someone is experiencing narrowing of the airways due to both of these issues, one of these drugs will not be enough to resolve the underlying cause.

By ysmina — On Dec 28, 2014

I've been given an ipratropium and albuterol combination inhaler for bronchitis. But if ipratropium doesn't work as well and as fast as albuterol, why combine these two at all? Isn't it better to just use an albuterol inhaler?

Does anyone else here use a combination inhaler? What do you use it for?

By SteamLouis — On Dec 27, 2014

My sister has asthma and she uses an albuterol inhaler. It works really well for her. My sister has acute asthma. So she is not ill all the time but once she comes in contact with a trigger such as pollen, dust or another allergen like cigarette smoker or perfume, the asthma attack comes on very fast. It literally develops in seconds and she starts coughing and wheezing right away.

If there weren't medications like albuterol inhalers, I'm sure that my sister would be in big trouble. When she knows that an asthma attack is coming, she uses her inhaler a few times and she feels better instantly. We are so grateful that she has something that works for her and keeps her safe.

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