What should a mother administer to her daughter suffering from an asthma attack when Albuterol is ineffective?

Ipratropium bromide is the appropriate choice in this scenario when Albuterol, a short-acting beta-agonist, is ineffective during an asthma attack. As an anticholinergic medication, ipratropium works by blocking the action of acetylcholine in the airways, leading to bronchodilation and thus providing relief from bronchospasm. This makes it a useful adjunct therapy in acute asthma situations, especially when beta-agonists alone do not provide sufficient relief. It can also enhance the bronchodilatory effect when used in combination with albuterol.

Aqueous epinephrine, while effective in severe asthma attacks, is generally not used for routine management in children due to potential side effects and the need for more controlled administration routes. For children with asthma, inhaled medications like ipratropium are preferred for safety, efficacy, and ease of delivery.

Re-administering Albuterol would not be beneficial in this case, as the initial dose was ineffective, and giving additional doses without achieving a response does not address the underlying issue of the acute attack. Metaproterenol, an older beta-agonist, is less common in acute management today compared to albuterol and ipratropium, and does