Which of the following is a precaution associated with ipratropium bromide use?

• A. It is contraindicated in pregnancy
• B. It should be used with caution in patients with narrow-angle glaucoma
• C. It has no interaction with albuterol
• D. It is not administered with albuterol

Answer: (B)

Ipra­tropium bromide is an inhaled anticholinergic bronchodilator that blocks muscarinic receptors in airway smooth muscle to reduce bronchoconstriction. Because some systemic absorption can occur, its anticholinergic effects can affect other tissues as well. In people with narrow-angle glaucoma, anticholinergic drugs can cause pupil dilation that may narrow the angle and trigger acute angle-closure glaucoma, so ipratropium should be used with caution in these patients. This is the key precaution: avoid or monitor closely in narrow-angle glaucoma.

The other statements aren’t correct because ipratropium is not categorically contraindicated in pregnancy, it is commonly used with albuterol (there are inhalers and nebulations combining the two), and there isn’t a problematic interaction that would require avoiding concurrent use.