How do atrovent (ipratropium) & albuterol act differently in the lungs? my 5yo seems to do better when we add atrovent (ipratropium) nebs between her albuterol & pulmicort.

Mutually complement: Good morning, airway spasm in asthma results from net reduction in adrenergic (dilating) effect, or increase in bronchospastic (vagal) force. Albutrol promotes dilating force , while atrovent (ipratropium) blocks the constricting force - thus complementing the net beneficial effect on bronchial tubes. In asthma the symptoms are caused by decreased diameter of bronchial tubes.

See below : Both Atrovent (ipratropium) and albuterol are bronchodilators, meaning they relax the muscles and open up the airway, making it easier to breathe. At the chemical level, they work differently. They both produce the same effect in different ways, but either may be more helpful for different people at different times, consistent with what you’re noticing.