USE OF ANTICHOLINERGIC BRONCHODILATION IN CHILDREN

Ipratropium bromide is a quaternary ammonium anticholinergic bronchodi lator with minimal systemic absorption across the blood-airway barrier . Ipratropium bromide has become primary therapy for the treatment of adults with chronic bronchitis, but its use in children has been limit ed. Ipratropium bromide can be safely used in the management of acute bronchiolitis, recognizing that most infants do not appear to respond to any bronchodilator medication. When used with a beta-agonist bronch odilator for the therapy of acute childhood asthma, ipratropium bromid e appears to provide bronchodilation beyond that achieved by either ag ent used alone. There are insufficient published data to determine the appropriate use of ipratropium bromide in infants with bronchopulmona ry dysplasia, although many of those symptomatic after the age of 6 mo nths seem to benefit from either ipratropium bromide or beta-agonists. As ipratropium bromide has no intrinsic anti-inflammatory properties, its role in the chronic therapy of asthma and related disorders is st ill unclear.