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Chronic obstructive pulmonary disease - Management
Short-acting antimuscarinic: inhaler +/- spacer device

Age from 16 years onwards
Ipratropium CFC-free MDI: 1 to 2 puffs up to 4 times a day
Ipratropium bromide 20micrograms/actuation inhaler CFC free
Inhale one to two puffs three to four times a day.
Supply 1 200 dose inhaler.
Age: from 16 years onwards
NHS cost: £4.00
Licensed use: yes
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Patient information: Please follow the care instruction provided with this inhaler. This will ensure it works correctly.
AeroChamber Plus spacer device: for use with Atrovent inhaler
AeroChamber Plus
Use to aid inhalation.
Supply 1 spacer.
Age: from 16 years onwards
NHS cost: £4.43
Licensed use: no - misc item available on the NHS
Patient information: Seal your lips around the spacer mouthpiece and spray one puff only from the inhaler into the other end of the spacer. Breathe in slowly and deeply to inhale the dose and breathe out. The drug aerosol is very short lived so do not wait more than a few seconds to inhale the dose. If a second dose is required, repeat the process about 30 seconds later. Follow the instructions in all patient information leaflet carefully. Wash the spacer device thoroughly once a month with dilute washing up liquid, do not rinse and leave to air dry. Replace the device every 6 to 12 months.

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