Inhalation with saline solution for children and adults

A solution that has the same osmotic pressure as the fluids inside and outside the body cells is called isotonic or physiological. Do not look for a special saline solution for inhalations or saline for inhalations for a nebulizer, since a normal isotonic NaCl solution in distilled water (containing 9 mg of sodium chloride per 1 ml of solution) is used to directly affect the airways.

In this solution, the same content of Na and Cl ions, both in blood plasma and in medicine, is universally used for injections and infusions and in pure form, and mixed with various medicinal substances. So 0,9% solution of sodium chloride is saline solution for inhalations.

[1], [2], [3], [4], [5],

Indications Inhalation with saline solution

The main indications for the use of physiological solution include intravenous infusions - in cases of dehydration, poisoning, burns, blood loss and shock states - to maintain homeostasis by restoring the water-electrolyte balance.

In addition, saline solution for inhalation is widely used in complex therapy of diseases of the respiratory system.

In particular, saline is used for inhalation with cough accompanying acute respiratory-viral infections; laryngitis and tracheitis; acute and chronic forms of bronchitis; allergic bronchitis  and bronchial asthma; pleurisy and pneumonia. Inhalation with a solution of sodium chloride is prescribed for bronchiectasis, COPD and cystic fibrosis of the lungs.

Physiological solution for inhalation with a cold and difficult nasal breathing helps to remove the swelling of the mucous membrane of the nasal cavity, paranasal sinuses and airways of the nasopharynx in the presence of acute respiratory disease, rhinosinusitis, nasopharyngitis, vasomotitis rhinitis, sinusitis, and frontitis. In the same cases, as well as with  stenosing laryngotracheitis  , inhalations are carried out with saline for children, including inhalation with saline solution for newborns.

Regular inhalation with a solution of NaCl (once or twice a day for 5-10 ml) promotes the moistening and partial regeneration of the mucous epithelium in the nose with atrophic rhinitis and the rhinosclerome. Effective inhalation saline for prevention of exacerbation of allergic rhinitis.

[6], [7]

Release form

Pharmacy sodium chloride is available in the form of powder and tablets to prepare a solution (tablets of 0.9 g).

The ready 0.9% isotonic solution of NaCl for injection (i.e., sterile) is available in ampoules (5 ml and 10 ml), as well as in hermetically sealed bottles (100, 200 or 400 ml) and p / p containers 250 and 500 ml - for use in a hospital).

For inhalation, any of the listed forms are suitable, but packaged in vials or saline in ampoules for inhalations are recommended for use in a nebulizer or compression inhalers with a spacer.

Inhalations with saline solution

Compatibility of saline with most pharmacological agents allows the preparation of inhalation formulations of targeted therapeutic action with the addition of certain medications whose pharmacodynamics do not change due to dilution with a solution of sodium chloride.

What to add to saline solution for inhalations? And what should be the dosage and the proportions of saline for inhalations?

First of all, for inhalation solutions for coughing with viscous sputum, which is difficult to remove from the bronchi, means are used for liquefaction and facilitating the expectoration of phlegm.

The most commonly used saline solution for inhalations for a nebulizer with drugs whose active ingredient is ambroxol hydrochloride: Ambroxol and antimicrobials Ambrobe, Ambrohexal, Lazolvan, etc. So, when you are assigned Ambroxol for inhalation with saline, Ambrohexal or Ambrobene with saline solution for inhalations , as well as saline with Lazolvan for inhalations, you need to know that these are just different trade names of the means with the same active component.

Mucolytic and expectorants with acetylcysteine are used: dilution-free acetylcysteine solution for inhalations of 20% (in ampoules of 5 ml), sterile solution of Mukomist (in the same packaging), solution of Fluimucil for injection and inhalation (in 3 ml ampoules). According to the official instruction, Fluimucil is not mixed for inhalations with saline solution, but the contents of one ampoule are used for one procedure (the drug is not used for children under two years old). If the fluuimycil antibiotic IT is prescribed (another name is Tiamfenicol glycinate acetylcysteinate) in the form of a lyophilized powder packaged in vials for the preparation of an injection and inhalation solution, then in this case saline is not needed: water for injections (in ampoules 4 ml each).

With bronchial spasms associated with bronchial asthma, with chronically occlusive obstructive bronchitis, in cases of bronchitis with emphysematous component, physiological saline with Berodual for inhalation may be prescribed - for enlarging bronchioles.

Patients with chronic inflammation of allergic bronchi are prescribed Budesonide or Pulmicort with saline solution for inhalation, as well as other preparations of the group of fluorinated corticosteroids (Dexamethasone, Beclomethasone, etc.). With increasing stenosis of the larynx, which can cause croup, not only systemic corticosteroids are used, but inhalation with saline solution for children through a nebulizer.

With nasopharyngitis (rhinitis) with nasal congestion due to swelling of his mucous and with sinusitis, Naphazoline or Naphthysine and saline are used for inhalation. The antiseptic Miramistin with saline solution for inhalations is used with the help of a nebulizer with inflammation of the pharynx and larynx, as well as bacterial tonsillitis.

[8], [9], [10], [11]

Ambroxol for inhalations with saline solution

Pharmacodynamics Ambroxol, Ambrobe, Ambrohexal, Lazolvan and other preparations based on ambroxol hydrochloride consists in the dilution of sputum due to the normalization of the secretory functions of the mucous glands in the bronchial epithelium, the activation of proteolytic enzymes that destroy the glycoproteins of the mucosal bronchial secretion, which together contributes to the restoration of mucociliary clearance.

In inhalation applications and exposure to mucous membranes of the respiratory tract, their pharmacokinetics are not described in the instructions.

Use during pregnancy Ambroxol in the form of a solution for oral administration and inhalation during the first trimester is contraindicated. However, it is stated that during his 28-34 week period, his inhalations with saline are effective in preventing the development of such a dangerous respiratory disorder in the birth of premature babies, such as respiratory distress syndrome (due to the immaturity of the lungs and the inadequate production of the alveolar surfactant).

Possible side effects of inhalations with Ambroxol are a violation of taste, dry mouth, the appearance of nausea, dyspepsia.

The method of using Ambroxol for inhalations with saline solution involves the use of a nebulizer or compression inhalers with a mask. The proportions of the drug and saline solution are 1: 1.

Is it possible to warm saline for inhalations? The solution should be heated to + 38 ° C. For adults and children over the age of six, the dose for one inhalation is 2.5 ml of Ambroxol solution. How much saline is needed for inhalation? In this case, too, 2.5 ml. The procedure can be carried out twice a day.

Inhalation with saline solution for children of two to six years is also carried out twice a day - 2 ml of Ambroxol (Ambrobe, Ambrohexal or Lazolvan) plus the same saline solution. A single dose for children under two years is 1 ml of the drug mixed with the same amount of sodium chloride solution.

Read also the material -  Inhalation with bronchitis.

[12], [13], [14], [15]

Physiotherapy with Berodual for inhalations

The mechanism of the  bronchodilator ( dilating bronchial) action of Berodual, released in the form of a solution for inhalation use (in bottles with a dropper ), is provided with β2-adrenomimetic fenoterol hydrobromide stimulating β2-receptors of adrenaline  smooth muscle  walls of bronchi, and m-anticholinergic bromide ipratropium, which blocks their parasympathetic innervation. As a result, the smooth musculature of the bronchi relaxes.

The use of this drug in the first and third trimesters of pregnancy is contraindicated; In the second trimester, Berodual's use for inhalations in bronchial asthma or obstructive bronchitis requires caution.

Also among the contraindications are cardiac pathologies with heart rhythm disturbances, myocardial ischemia, aortic stenosis, elevated thyroid hormone levels, and prostate enlargement.

Using Berodual for inhalation can cause side effects such as coughing, dry mouth, blurred vision, headache and dizziness, tremors and muscle spasms, palpitations, increased sweating and blood pressure, bowel and bladder disorders.

Dosing and Administration

The standard single dose of Berodual for adults and children over the age of six is 10-20 drops (no more than four procedures per day); for the termination of an attack of an asthma a dose - 20-80 drops. Children younger than this age, this drug is used in doses calculated by body weight, and inhalations are carried out in a medical institution (since this drug can strengthen bronchial obstruction and cause bronchospasm up to stopping breathing).

How much saline is needed for inhalation is determined by the number of drops of Berodual: 10 drops = 0.5 ml (2.5-3.5 ml of saline is required); 20 drops = 1 ml (2-3 ml of saline is required). These proportions can not be violated.

Overdose of saline with Berodual for inhalation is fraught with cardiac arrhythmia, irregular blood pressure, a decrease in the potassium content in the blood and an acid-base violation, with the development of metabolic acidosis.

Interactions with other drugs: saline with Berodual for inhalations are not used simultaneously with oral administration of other adrenomimetics or anticholinergics, theophylline and theobromine, cardiac glycosides, corticosteroids and diuretics.

[16], [17], [18], [19]

Pulmicort with saline solution for inhalations

Dosage suspension for inhalation Pulmicort is used as a means to prevent exacerbation of bronchial asthma and COPD. Corticosteroid budesonide (the active substance of the drug) affects the GCS receptors of the lung tissue and prevents the release of proinflammatory cytokines and bronchial narrowing leukotrienes, and also reduces blood circulation in the bronchi, their swelling and the production of bronchial secretions.

Pharmacokinetics: Budesonide is well absorbed by the mucosa of the respiratory tract and enters the bloodstream with bioavailability of about 15% and binding to serum proteins at 90%; metabolized by the liver; is excreted by the kidneys.

Use during pregnancy only for medical reasons.

Contraindications for use include diseases of the respiratory system of a bacterial, viral or fungal etiology. Suspension for inhalation is not permitted for children of the first six months of life.

Pulmicort with saline solution for inhalation can give side effects in the form of dermatitis, Quincke's edema, development of candidiasis of the oral cavity and pharynx, cough, hypokorticism, increased nervous excitability or depressive state.

Suspension for inhalation Pulmicort is used in an individually calculated dosage. The standard daily dose for children older than six months is 0.25-0.5 mg; for adults 1-2 mg. Dosage and proportions of saline for inhalations -1: 1, that is, a dose of Pulmicort 0.25 mg (this is 1 ml of suspension) should be diluted to give 2 ml of the solution for inhalation. The remaining doses by volume ≥ 2 ml, and there are no instructions for adding saline.

Overdose is possible with prolonged use of this drug, and its effects over time are manifested signs of the syndrome Itenko-Cushing.

The only tracked interaction between busedonide and other drugs is to increase its therapeutic effect with preliminary inhalation with bronchodilators (Berodual, Salbutamol, Terbutalin, etc.).

Naphthysine and saline for inhalation

To Naphazoline or Naphthyzine with saline solution for inhalation had an effect on the inflamed mucous nasal passages, sinuses and nasopharynx, you need to use an inhaler with a mask.

The active substance - nafazolin - belongs to the group of anticongestants, that is, decongestants, which act due to the vasoconstrictor effect, stimulating adrenergic receptors (alpha1 and alpha2). This reduces the swelling of the mucous membranes (nasal breathing normalizes), while the amount of nasal mucus secretion produced decreases.

The form of the release of Naphthyzin is 0.05-0.1% solution for instillation into the nose.

Use of Naphthyzin during pregnancy and lactation is prohibited. It is inadmissible for children under the age of two.

Naphthyzin and inhalations with it are contraindicated with increased blood pressure, atherosclerosis, glaucoma, diabetes, chronic forms of rhinitis.

Among the side effects of this drug from the common cold are headache and tachycardia. Also, the drug can cause tachyphylaxis and dependence.

Dosage and proportions of saline for inhalation with Naphthysin: 1 ml of a 0.05% solution of Naphthysin is diluted with 2 ml of saline solution; 1 ml of 0.1% solution - 5 ml of saline.

Not more than two inhalations per day are allowed.

Miramistin with saline solution for inhalations

Miramistin is an antiseptic that is not registered in the EU Pharmacopoeia and is available in the form of a 0.01% topical solution.

It is possible to use it for sinusitis and tonsillitis during pregnancy and for inhalation with saline solution for children with rhinitis with purulent discharge from the nose.

The use of Miramistine can be accompanied by burning, itching and hyperemia of the mucous membranes.

The drug should be inhaled through the nose, so you need an inhaler equipped with a mask mask. Saline dilution is carried out in this ratio: 2 ml Miramistin 4 ml of saline is necessary. It is recommended to do on the day two inhalations lasting 3-5 minutes.

PhysRosin and Dioxydin for inhalations

In occasion of inhalations with bactericidal agent Dioxydin, which are recommended for adult patients for the treatment of nasopharyngeal diseases with the formation of purulent exudate, doubt arises.

According to the instruction, neither for instillation into the nose nor for inhalations, the solution of Dioxydin is not intended: it is applied externally (irrigation of the surfaces of burns and tamponing of deep wounds) and into the purulent cavities; injected intravenously by infusion (diluted with a solution of dextrose or saline solution) with inflammatory processes of a purulent-septic nature

Information on the proportions of dilution of Dioxydin for inhalation can not be considered reliable.

How to replace saline for inhalations?

In principle, physiological saline for inhalations can be replaced with distilled water. And you can cook it at home, stirring in one liter of warm boiled water 9 g of table salt - a teaspoon with a small slide. The solution should be filtered.

Sterile such solution will not be, as well as prepared from chemist's sodium chloride in powder or tablets, but its suitability for carrying out inhalations this interferes.

Storage conditions

Incomplete pharmacological saline for inhalations should be stored at room temperature. Postal and cooked yourself - in the refrigerator. Can I use open saline for inhalations? If the closed vialed bottle with saline is kept in the refrigerator, it can be used for three days. But the solution for inhalation with the addition of other drugs is not subject to storage and is used immediately after preparation.

[20], [21], [22], [23], [24]

Shelf life

Sodium chloride in tablets and powder has no expiration date. Ready saline in ampoules godenv for five years, and in the facets - for one year.

[25], [26], [27], [28]

Reviews

In most cases, reviews of patients with respiratory diseases and inflammation of the nasopharynx used in the treatment of saline for inhalations, as well as inhalation formulations of the above medicines, are positive. Often administered to adults and children, inhalation therapy is faster and more effective than taking drugs inside.