DuoNeb is a combination of which two agents?

• A. Ipratropium + Albuterol
• B. Ipratropium + Tiotropium
• C. Albuterol + Salmeterol
• D. Ipratropium + Atropine

Answer: (A)

DuoNeb combines ipratropium bromide with albuterol sulfate to provide bronchodilation through two different mechanisms. Ipratropium is an anticholinergic that blocks muscarinic receptors in the airways, reducing acetylcholine-triggered bronchoconstriction and secretions. Albuterol is a short-acting beta-2 agonist that relaxes bronchial smooth muscle by increasing cAMP, producing rapid bronchodilation. Using them together often yields greater airway opening than either alone, which is why this nebulized pair is used for acute bronchospasm and COPD exacerbations.

The other combinations don’t fit because tiotropium is a long-acting antimuscarinic used for maintenance rather than in this acute nebulized mix, salmeterol is a long-acting beta-agonist meant for chronic control, and atropine isn’t the inhaled duo used in clinical practice.