Aerobidol Overdosage

Acute overdose by inhalation is unlikely because ipratropium is not well absorbed systemically after inhalation or oral administration. Oral median lethal doses of ipratropium were greater than 1,000 mg/kg in mice (approximately 20,000 times the maximum recommended daily inhalation dose in adults on a mg/m2 basis); 1,700 mg/kg in rats (approximately 68,000 times the maximum recommended daily inhalation dose in adults on a mg/m2 basis); and 400 mg/kg in dogs (approximately 53,000 times the maximum recommended daily inhalation dose in adults on a mg/m2 basis).
Symptoms: The expected effects of over dosage may be related to fenoterol as excessive beta-adrenergic stimulation, particularly cardiovascular symptoms such as tachycardia, palpitation, tremor, hypertension, hypotension, widening of the pulse pressure, anginal pain, arrhythmias and flushing. The symptoms due to ipratropium bromide (eg, dry mouth, visual accommodation disturbances) are mild because low systemic absorption. Although uncommon fatalities have been reported in association with excessive use of inhaled sympathomimetics. The exact cause of death is unknown. Whether the fatalities are associated with disease severity, substandard quality of care, and/or patient noncompliance has not been established.
Treatment: Monitor the patient carefully, especially for cardiovascular status and supportive care for patients in whom intentional overdose is confirmed or suspected should be referred for psychiatric evaluation. The administration of sedatives, tranquilizers may be necessary in severe cases intensive therapy. Beta1-receptor blockers are specific antidotes but the dosage should be adjusted carefully in patients suffering from bronchial asthma or COPD since it may be increase in bronchial obstruction and risk of severe bronchospasm and fatal.