Salbutamol sulfate and ipratropium bromide is an anticholinergic (parasympatholytic) agent which acts by inhibiting vagally-mediated reflexes by antagonizing the action of acetylcholine, the transmitter agent released from the vagus nerve. Salbutamol is a relatively selective β2-adrenergic agonist whose activation leads to the increase in the intracellular adenyl cyclase, the enzyme which catalyzes the conversion of adenosine triphosphate (ATP) to cyclic-3'5'-adenosine monophosphate (cAMP).