Pharmacological properties Ventolin HFA Inhaler:
salbutamol (1 – (4-hydroxy-3-gidroksimetilfenil) -2 – (ter-butylamino) ethanol) – a selective β2-adrenoceptor agonist. At therapeutic doses, has an effect on β2-adrenergic receptors in the bronchi, causing bronhodilatiruyuschy effect with minimal or no effect on β1-adrenergic receptors in heart. Salbutamol causes bronchodilation in patients with reversible airway obstruction that occurs as a result of asthma, chronic bronchitis and emphysema. Salbutamol is used as an attack to relieve bronchospasm, and for long-term therapy to prevent attacks of asthma.
After inhalation of 10-20% of the administered dose reaches the lower respiratory tract. Partly deposited in the nasopharynx and upper parts of airways from which swallowed. The drug, which reached the lower respiratory tract, is absorbed and enters the systemic circulation, the lungs are not metabolized.
Onset of action of the drug – after 4-5 minutes after inhalation, duration – 4-6 hours
After entering the systemic circulation the drug is metabolized in the liver and excreted primarily in the urine in unchanged form and as fenolsulfatnogo metabolite.
Part of the dose received from the nasopharynx into the digestive tract, which is primarily metabolized in the liver fenilsulfatnoe connection, and then excreted by the kidneys.
Indications: relief and prevention of bronchospasm in asthma, chronic bronchitis or emphysema, long-term therapy for patients with asthma as a component of the treatment. C prophylactic use immediately before exercise or possible contact with the allergen to prevent an asthma attack.
APPLICATION Ventolin HFA Inhaler:
Ventolin Evohaler
Prescribed only by inhalation. Designed for use in adults and children over 2 years. Patients who have difficulty coordinating inhalation with a spray inhaler, a spacer is recommended. Young children should be used for inhalation device Bebihaler.
Increased need for β2-agonists indicates a worsening of asthma. In this case, you should review the patient’s treatment regimen and decide whether to use SCS therapy.
The need to increase the dose and frequency of inhalation is determined only by a physician, taking into account the possible side effects in case of exceeding the dosage.
Relief of acute bronchospasm: Adults appoint 100-200 microns (1-2 doses), children – 100 mcg (if necessary the dose may be increased to 200 mcg), prevention of bronchospasm induced by exercise or exposure to allergen, administered 200 mcg for adults before exercise or exposure to allergen, the children – 100 mg before exercise or exposure to an allergen (the dose for children in need can be increased to 200 micrograms). Long-term treatment of asthma: adults administered at a dose of 200 mg 4 times a day for children – up to 200 mg 4 times a day. The frequency of Ventolin “on demand” should not exceed 4 times a day. The frequency of such use Ventolin or a sudden increase in dose may be an indication of acute asthma.
Ventolin Nebula
The drug is intended for inhalation by breathing through the mouth. Ventolin Nebula is usually used in undiluted form. However, if inhalation should be carried out for a long time (more than 10 min), the contents of the Nebula can be diluted with isotonic p-rum sodium chloride. Ventolin is used Nebula using the nebulizer under medical supervision. Pp is not designed for injecting or swallowing. Inhalation aerosol may be conducted by a special mask or mouthpiece. You should periodically ventilate the room, which hosts inhalation. In case there is a risk of lack of oxygen due to hypoventilation add it in the inspired air. Increase the dosage or frequency of use of the drug may be a doctor. Adults and children: application of inhalation of salbutamol usual starting dose is 2.5 mg. Dose can be increased to 5 mg. Repeated inhalation may be 4 times a day. In adults with severe airway obstruction dose may be increased to 40 mg / day, but treatment with these doses should be carried out in hospital under medical supervision. The clinical efficacy of salbutamol by nebulization in infants under 18 months is not installed. As can be transient hypoxemia, should take into account the need for additional carrying oxygen therapy.
CONTRAINDICATIONS Ventolin HFA Inhaler:
Hypersensitivity to the drug.
SIDE EFFECTS Ventolin HFA Inhaler:
Side effects listed below are classified by organs and systems, as well as the frequency of occurrence: very common (≥ 1 / 10), common (≥ 1 / 100,
By the immune system
Very rare – hypersensitivity reactions, including angioedema, urticaria, bronchospasm, hypotension and collapse.
Digestive disorders, and metabolic
Rarely – hypokalemia. The use of β2-adrenergic agonists can cause the development of severe hypokalemia.
The nervous system
Often – tremor, headache.
Very rare – hyperactivity
From the heart
Often – tachycardia.
Very rare – cardiac arrhythmia, including fibrillation, supraventricular tachycardia and extrasystoles.
Vascular disorders
Rarely – peripheral vasodilatation.
The respiratory system
Very rarely – paradoxical bronchospasm. As with other inhaled funds may develop paradoxical bronchospasm with an immediate increase in wheezing after treatment. In this case it is necessary to appoint an alternative formulations of a drug or other fast inhaled bronchodilators. Ventolin Evohaler should be abolished, to assess the patient’s condition and if necessary, to begin an alternative therapy.
Gastrointestinal
Uncommon: irritation of the mucous membranes of the oral cavity and pharynx.
On the part of the musculoskeletal system
Uncommon: muscle cramps.
Precautions Ventolin HFA Inhaler:
Treatment of asthma should be conducted in accordance with the phased program, and should assess the patient’s clinical condition and pulmonary function tests carried out. Increasing demand for β2-adrenergic agonists may indicate a deterioration of asthma control. In such a situation should be reviewed and treatment plan to appoint the SCS.
Patients at risk are encouraged to daily pikofloumetriyu.
If you use Ventolin in the previous effective dose not improve the condition of the patient within 3 hours, you should reconsider the treatment regimen.
Ventolin Nebula caution is used to treat patients receiving high doses of other simpatomimetokov.
When treating patients with a combination of salbutamol and ipratropium in Nebula bromide sometimes noted cases of acute attack of angle-closure glaucoma. Therefore the combination of salbutamol in Nebula with anticholinergic drugs, inhaled as inputs should be applied with caution.
Salbutamol administered with caution to patients with thyrotoxicosis.
With long-term treatment of β2-adrenergic agonists may develop severe hypokalemia, usually in the appointment of dosage forms for parenteral administration or by using a nebulizer. Particular attention should be given to patients with severe asthma, because hypokalemia may increase the severity of hypoxia, as well as the concomitant use of xanthine, corticosteroids and diuretics. In this situation, it is recommended to control the level of potassium in the blood serum.
Like other β-agonists, adrenergic receptors, Ventolin Nebula may cause reversible metabolic changes such as increased blood glucose levels. Compensate for these changes in diabetic patients is not always possible, so there are reported cases of ketoacidosis in these patients. The simultaneous use of corticosteroids may aggravate the condition.
During pregnancy and breast-feeding: drug is prescribed only if the expected benefit to the mother outweighs the potential risk to the fetus.
Based on the fact that salbutamol may be excreted in breast milk and its role in breast-feeding may be recommended only when the expected benefit to the mother exceeds potential risk to the child.
Effect on ability to drive motor vehicles and other mechanisms: there is no evidence of an effect.
Drinking: Nebula content may be diluted solution of sodium chloride. Unused pp medication from the nebulizer should be discarded. Patients should be warned that the p-p and not spill should avoid contact with mucous aerosol spray eye.
Interactions Ventolin HFA Inhaler:
The drug is not recommended in conjunction with non-selective blockers of β-blockers (propranolol).
Salbutamol is not protipokazan patients receiving MAO inhibitors.
Overdose Ventolin HFA Inhaler:
Symptoms of overdose may be manifested in excessive stimulation of β-blockers and / or side effects of varying degrees of severity. Treatment consists of withdrawal of salbutamol and of the corresponding symptomatic therapy. Antidote, which should be favored with an overdose of salbutamol is a cardioselective β-blocker. Drugs of adrenergic β-blockers should be prescribed with caution in patients with a history of bronchospasm.
As a result of an overdose of salbutamol may cause severe hypokalemia, so you should check the level of potassium in the blood serum.
