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In one study the decrease in attention performance was similar between the acute intoxication and hangover states while reaction times were worse in the hangover state, raising safety concerns

It was tested in patients with coronary artery disease and it showed none of the adverse effects of its predecessor whilst increasing cholesterol efflux (Reijers et al., 2017

(1) The quaternary ammonium structure of ipratropium carries a positive charge, limiting its systemic absorption and preventing significant penetration into the central nervous system, thereby confining its effects primarily to the pulmonary system