Inhalations with pulmicort: can and how much to do?

An effective inhalation drug is Pulmicort. Let's consider the main indications for its use, dosage, and mechanism of action.

The drug is a glucocorticoid. It is used for respiratory diseases. It is effective in the treatment of bronchial asthma, as it affects all links of the pathological process. The active components affect glucocorticosteroid receptors, regulate the synthesis of various substances. The main targets of the drug are genes encoding and suppressing the synthesis of anti-inflammatory components.

• Blocks the combination of anti-inflammatory and bronchoconstrictor substances.
• Enhances the bronchodilatory effect of adrenergic drugs and increases the sensitivity of b2-adrenergic receptors.
• Reduces bronchial blood flow and decreases the synthesis of nitric oxide, which stimulates bronchospasms.

Pulmicort is similar in its mechanism of action to glucocorticoid receptors, but its effectiveness is 15 times higher than prednisolone. It has low lyophilicity, therefore it has high penetrating ability relative to the mucous secretion layer in the bronchi. It penetrates tissues well. Due to its high selectivity, metabolites are practically not detected in blood plasma. Due to its low systemic activity, binding to plasma proteins is minimal.

Antianaphylactic action is aimed at reducing bronchial obstruction in relation to early and late allergic reactions. Reduces bronchial edema, airway hyperreactivity, and reduces sputum formation. The earlier the treatment is started, the higher the effectiveness of the drug.

[ 1 ]

Indications Pulmicorta

Pulmicort belongs to the pharmacological group of glucocorticoids. Inhalation agent for the treatment of obstructive respiratory diseases. The main indications for its use are:

• Persistent bronchial asthma (if maintenance therapy with glucocorticosteroids is required).
• Chronic obstructive pulmonary disease (moderate, severe).

Most often, the drug is prescribed for the treatment of bronchitis in children and adults. The drug is effective at any stage of the disease. Also, indications for the use of Pulmicort are:

• Prolonged cough of unknown etiology.
• Laryngotracheitis.
• Pharyngitis.
• Laryngitis.
• Rhinitis of various etiologies.
• Pulmonary pathologies, emphysema.

The drug can be used for severe allergic reactions, anaphylaxis and asthma attacks caused by various allergens. Inhalation administration of the drug eliminates muscle spasms, swelling and inflammation. Thanks to this, free breathing is restored and the recovery process is accelerated.

Pulmicort for inhalation in bronchitis

For the treatment of severe upper respiratory tract diseases in children and adults, in addition to the main therapy, doctors often prescribe inhalation drugs. Such drugs include Pulmicort, which is especially effective for bronchitis.

Bronchitis is an acute, usually infectious disease affecting the mucous membrane of the bronchi. Most often, it is a complication of influenza or acute respiratory viral infection, so it is seasonal. In some cases, bronchitis occurs due to chemical or physical factors. The duration of the disease is about 2-3 weeks. Bronchitis can be acute or chronic. The latter is classified by morphology, functional disorders, course and presence of complications.

Pulmicort for inhalation in bronchitis has the following effect on the affected area:

• Anti-inflammatory.
• Decongestant.
• Immunosuppressant.
• Antiallergic.

The medicine eliminates bronchospasms, reduces the amount of sputum in the bronchial tree and helps remove it from the body. Inhalations act directly on the bronchial mucosa. The maximum concentration of the active substance is achieved 20-30 minutes after application. Thanks to this, the swelling of the mucosa subsides and breathing is restored.

The medication is used with a nebulizer, diluted with saline or in the form of a ready-made inhalation canister. The dosage and duration of treatment are determined by the attending physician, individually for each patient.

For laryngitis

Laryngitis is an inflammatory disease that affects the mucous membrane of the larynx. Most often, this pathology is diagnosed in children. Without timely and proper treatment, the disease causes various complications.

The appropriateness of using Pulmicort for inhalation in laryngitis is explained by its properties:

• Antianaphylactic.
• Antispasmodic.
• Decongestant.
• Anti-inflammatory.

The drug reduces swelling of the laryngeal mucosa, suppresses local allergic reactions and relaxes the smooth muscles of the respiratory tract. The active component inhibits the synthesis of proinflammatory biologically active compounds. The inhalation agent creates favorable conditions for the further use of bronchodilators.

For children under 6 months, 0.5-1 mg per day is prescribed. For patients up to 12 years and older, inhalations are carried out 2-3 times a day. Pulmicort is a prescription drug, it is used only as prescribed by a doctor in compliance with the recommended dosage.

For allergies

One of the indications for the use of Pulmicort is an allergic cough. The painful condition develops due to the effect of various allergens on the upper respiratory tract. The drug stops anaphylactic reactions, restoring breathing. Its active substance relieves swelling of the mucous membranes of the larynx and bronchi, easing an attack of suffocation.

The hormonal drug is approved for the treatment of allergies in both children and adults. Inhalations through a nebulizer are effective for dry allergic cough with viscous sputum. To perform the procedure, the medicine is diluted with saline or combined with antihistamines.

Pulmicort for inhalation for dry cough

Dry cough occurs for various reasons. It can be associated with inflammatory processes in the body or the action of allergens. One of the methods for relieving coughing fits is inhalation with Pulmicort.

The medicine is effective for the following diseases:

• Chronic obstructive pulmonary disease.
• Rhinitis (chronic, acute).
• Bronchial asthma.
• Non-allergic asthma.
• Upper respiratory tract infections.
• Chronic cough of unknown etiology.

The drug contains budesonide. The active substance has anti-inflammatory and anti-allergic properties. With the help of inhalations, the active component affects the mucous membrane of the respiratory tract, relieving its irritation.

Inhalations should be performed only on doctor's prescription. This is due to the fact that the drug has a number of contraindications: pulmonary tuberculosis stage 3-4, viral skin infections, intolerance to the active components of the drug, kidney disease. It is also necessary to consider the risk of developing side effects with an incorrect dosage of the drug or its long-term use.

[ 2 ], [ 3 ]

Pulmicort for inhalation for adenoids

Adenoids are an overgrowth of the pharyngeal tonsil, which causes its inflammation. Inhalations for adenoiditis are aimed at reducing the rate of adenoid growth and reducing painful symptoms.

Pulmicort for adenoids can be used both at the stage of remission of the disease and during its exacerbation. Therapeutic effect of inhalations:

• Reduce swelling of the mucous membrane.
• Prevent and relieve inflammatory processes.
• Improves the outflow of lymph and blood.
• Strengthen local immunity.
• Stops coughing fits.
• Moisturize dry mucous membranes.
• They thin mucus and reduce the severity of a runny nose.
• They prevent the development of such complications as pharyngitis, tracheitis, and laryngitis.

Inhalations with Pulmicort for adenoids are primarily aimed at relieving the symptoms of inflammation of the pharyngeal tonsil. Treatment procedures are carried out through a nebulizer. However, inhalations are not recommended for patients with frequent bronchospasms, a tendency to nosebleeds. If the adenoids are at stage 2-3, the effect of inhalations will be insignificant. In this case, the main method of therapy is surgery.

[ 4 ], [ 5 ]

At temperature

Unlike traditional steam inhalations, which are prohibited at elevated temperatures, procedures through a nebulizer do not have such contraindications. That is, the use of Pulmicort for inhalations at a temperature is quite possible.

During inhalation, the drug has a local effect, as it acts directly on the mucous membrane of the pharynx, nasopharynx and bronchi. The active substances do not penetrate into the systemic bloodstream and do not affect the functioning of internal organs.

If the temperature has increased after using a nebulizer, it is quite possible that this is the result of the drug. In this case, you should consult with your doctor to prevent complications. If the elevated temperature is accompanied by vomiting, then inhalations are not performed. Also, contraindications include intolerance to the components of Pulmicort.

[ 6 ]

Release form

Pulmicort is available in several forms, which allows you to choose the most convenient way to use the medicine.

• Powder inhaler with a dispenser. Contains round granules crushed into a fine powder. The aerosol may contain a powder fraction. The inhaler is designed for 100 and 200 doses.

• Suspension for inhalation through a nebulizer in 2 ml containers, 20 nebulas per package.

Both forms of release contain the active substance - budesonide. Each dose of inhalation is 100, 200 mcg of the active component.

[ 7 ]

Pulmicort 0.25 and 0.5

One of the forms of Pulmicort is a suspension for inhalation. 1 ml of suspension for spraying contains 0.25 or 0.5 mg of budesonide. The excipients of the drug are: sodium chloride, disodium edetate, sodium citrate, citric acid, polysorbate 80 and purified water. The glucocorticoid is available in single-dose polyethylene containers.

[ 8 ], [ 9 ]

Suspension

The dosed suspension for inhalation contains the active component - micronized budesonide 0.25 mg or 0.5 mg. The substance is easily resuspended, sterile, white.

Pulmicort suspension is available in single-dose polyethylene containers. The drug is packaged in 5 containers packed in an aluminum foil envelope. Each pack contains 4 such envelopes.

[ 10 ], [ 11 ], [ 12 ]

Solution for inhalation

For inhalations using a nebulizer, use Pulmicort solution (suspension). The medicine is available in disposable polyethylene containers of 2 ml. The inhalation solution is effective in the following cases:

• Coughing attacks of various origins.
• Allergic reactions with anaphylaxis.
• Bronchitis.
• Laryngitis.
• Bronchial asthma.
• COPD.
• Rhinitis.

The dosage of the drug and the frequency of inhalations are determined by the attending physician. The daily dose for children is 0.25-0.5 mg, and for adults 1-2 mg. As a solvent, Pulmicort is mixed with a physiological solution. The use of distilled water or any other liquid is contraindicated.

If several drugs are prescribed for inhalation, bronchodilators are used first, mucolytics after 10-15 minutes, and anti-inflammatory drugs after the sputum has cleared.

Powder for inhalation

Pulmicort Turbuhaler is a powder form of a medicine used for inhalation. The medicine is available in plastic bottles of 100 mcg/dose and 200 mcg/dose. The inhaler consists of a dosing device, a container for storing powder and desiccant, a mouthpiece and a lid. The Turbuhaler is convenient to carry and use as needed.

[ 13 ]

Pulmicort inhalation drops

The inhalation drug for the treatment of obstructive diseases of the upper respiratory tract has several forms of release and dosages. One of them is a suspension in special disposable bottles. Therapeutic procedures are carried out using a nebulizer.

Inhalation drops are mixed with saline in the proportions prescribed by the doctor. Pulmicort has a local effect on the mucous membranes. It has pronounced anti-inflammatory and anti-allergic properties. A persistent clinical effect develops within 5-7 days of a course of medication use.

Pharmacodynamics

Pulmicort belongs to the pharmacological group of glucocorticosteroids, therefore it has a complex effect on the body:

• Anti-inflammatory.
• Pain reliever.
• Antiallergic.

The medicine is used by inhalation, so it primarily has an anti-inflammatory effect. The active substances reduce swelling of the bronchial mucosa, block cells that secrete mediators of allergic reactions. Due to this, bronchial blood flow and the synthesis of nitric oxide, which stimulates bronchospasms, are reduced.

The mechanism of action of the drug is similar to glucocorticoid receptors. Pulmicort has low lyophilicity and high penetrating ability relative to lung tissue. Antianaphylactic properties of the drug reduce bronchial obstruction in relation to early and late allergic reactions and reduce the formation of sputum.

The mechanism of action and pharmacological properties of Pulmicort are determined by its active components. The drug contains budesonide, a GCS with a pronounced anti-inflammatory effect. It inhibits the release of inflammation mediators and suppresses the immune response of cytokines.

The therapeutic effect of the drug begins immediately after its inhalation use and reaches its peak within 2-3 hours. Improvement in pulmonary function occurs within 2 days from the start of therapy and lasts for about 4 weeks.

[ 14 ], [ 15 ]

Pharmacokinetics

Inhaled budesonide is rapidly absorbed. Its maximum concentration in blood plasma is reached within 30 minutes. The accumulation of the active component in the lungs is 25-35% of the dose taken. Systemic bioavailability is about 35%. Plasma protein binding is 90%, and the distribution volume is 3 l/kg.

The pharmacokinetics of Pulmicort are proportional to its dose relative to the dose taken. The active substance undergoes significant first-pass metabolism in the liver. The metabolites have low glucocorticosteroid activity. It is excreted in the urine unchanged or conjugated. A small amount of unchanged budesonide may be detected in the urine.

[ 16 ], [ 17 ], [ 18 ], [ 19 ], [ 20 ]

Dosing and administration

Synthetic corticosteroid, effectively relieves symptoms of bronchopulmonary diseases. Quickly relieves swelling of the bronchial mucosa, eliminates bronchospasms and has an anti-inflammatory effect. Active ingredient - budesonide in a dosage of 0.5 and 0.25 mg / ml.

Main indications for the use of Pulmicort for inhalation in adults:

• Bronchial asthma.
• Chronic obstructive pulmonary disease.
• Cough of unknown etiology.
• Larengotracheitis, laryngitis, pharyngitis, rhinitis.
• Pulmonary pathologies.
• Acute allergic reactions with anaphylaxis.

Due to inhalation application, the active substance acts directly on the lesion, restoring normal breathing. Budesonide does not penetrate into the systemic bloodstream and does not affect the functioning of internal organs and systems. The effect of the drug begins immediately, but the maximum therapeutic effect develops within 1-2 weeks.

Inhalations for adults can be carried out using a nebulizer, diluting Pulmicort with saline. The metered-dose inhaler Turbuhaler has also proven itself well. The duration of therapy and the required dosage should be determined by the attending physician, since this GCS is a prescription drug.

Pulmicort is intended for inhalation use using a nebulizer or metered dose inhaler. The dosage and duration of therapy are determined by the attending physician, individually for each patient.

When using Pulmicort Turbuhaler, the following rules must be followed:

• Strictly adhere to the dosage prescribed by your doctor.
• Inhale strongly and deeply through the nozzle, ensuring that the optimal dose of the drug enters the respiratory tract.
• Do not exhale through the nozzle.
• After the procedure, close the inhaler with the cap.
• Rinse your mouth with water after each inhalation to reduce the risk of developing oral thrush.

For chronic obstructive pulmonary disease, the recommended dose is 400 mcg twice daily. After inhalation of a single dose, the therapeutic effect develops progressively over several hours.

Bronchial asthma:

• Children 5-7 years old – 100-400 mcg per day, 2-4 inhalations.
• Children over 7 years old – 100-800 mcg per day, 2-4 inhalations.
• Adults – 200-800 mcg, divided into 2-4 doses.

In particularly severe cases, the dosage may be increased to 1600 mcg. For maintenance therapy, the dosage should be as low as possible.

[ 21 ]

How much to do per day and how many days to use?

In most cases, the effectiveness of inhalation is determined by the time it is performed. The maximum therapeutic effect of Pulmicort develops within 1-3 hours. The duration of the procedure depends on the dosage, the patient's age and the indications for use of the drug.

On average, inhalations with a nebulizer last from 5 to 10 minutes or until the solution in the device runs out. A stable therapeutic effect is achieved after 5-7 days of regular use of the drug.

Based on this, we can conclude that a single use of Pulmicort will not bring the desired therapeutic effect, but will help in emergency cases when it is necessary to restore normal breathing.

[ 22 ]

Pulmicort for inhalation for children

Despite the fact that Pulmicort is a hormonal drug, it is prescribed for the treatment of not only adults, but also children over 6 months. The main indications for inhalations with GCS are:

• Chronic obstructive pulmonary disease.
• Asthma of various etiologies.
• Infectious lesions of the upper respiratory tract.
• Pharyngitis, nasopharyngitis.
• The cough is dry and wet.
• Prevention of nasal polyps.
• Increased sensitivity to allergens.

The drug has proven itself as an emergency aid for bronchial asthma, laryngitis, laryngotracheitis and other conditions in which the breathing process is impaired due to swelling of the mucous membrane.

Inhalations are performed using a nebulizer. The device sprays the drug into dispersed particles, which are inhaled through a tube or mask and enter the respiratory organs. For the procedure, a suspension is used, diluting it with a 0.9% sodium chloride solution. The initial dosage is from 0.25 to 0.5 mg per day. In particularly severe cases, the doctor may increase the dose to 1 mg.

Before using the drug, it should be taken into account that it has a number of contraindications: age under 6 months, hypersensitivity to the components of the drug, pulmonary tuberculosis of 3, 4 degrees. If used incorrectly or exceeding the prescribed dosage, there is a risk of developing side effects: oral stomatitis, dry mouth, urticaria, increased excitability, decreased adrenal function, etc.

[ 23 ]

Use Pulmicorta during pregnancy

The use of inhaled glucocorticosteroids during pregnancy is possible when the expected benefit to the mother is higher than the potential risk to the fetus. At the same time, the studies conducted did not reveal any developmental disorders in the child during treatment with budesonide. After delivery, it is necessary to monitor the function of the adrenal glands of the newborn.

The active substance is excreted in breast milk, but its therapeutic doses do not affect the child. The final decision on the appropriateness and safety of using Pulmicort should be made only by the attending physician.

Contraindications

Synthetic glucocorticosteroid has a number of contraindications that should be taken into account before using it:

• Hypersensitivity to budesonide and other components of the drug.
• Patients under 6 months of age (inhalation suspension).
• Age up to 6 years (Pulmicort Turbuhaler).
• Pulmonary tuberculosis stages 3, 4.

The drug is prescribed with special caution to patients with active/inactive forms of pulmonary tuberculosis, liver cirrhosis, fungal, viral and bacterial diseases of the respiratory system, as well as during pregnancy and lactation.

Side effects Pulmicorta

As a rule, Pulmicort does not cause side effects, but in some cases the following symptoms may develop:

• Candidal infection of the oropharynx.
• Irritation of the mucous membranes of the respiratory tract.
• Cough and dry mouth.
• Nervousness and increased excitability.
• Clouded consciousness.
• Hypofunction of the adrenal cortex.
• Various allergic reactions.

Side effects may be caused by individual intolerance to the drug, its incorrect use or a general decrease in immunity.

To reduce the risk of oral and throat candidal infection, rinse your mouth with water immediately after inhalation. If the medication is prescribed to patients with chronic obstructive pulmonary disease, there is an increased risk of pneumonia. When using the drug for children, growth parameters and adrenal function should be regularly monitored.

Overdose

In case of a single excess of the doses of inhaled GCS prescribed by the doctor, the symptoms of overdose have no clinical manifestations. In case of chronic overdose, hypercorticism reactions and suppression of adrenal function develop:

• Arterial hypertension.
• Muscle weakness.
• Amenorrhea.
• Weight gain.
• Stretch marks.

For treatment, a gradual reduction in the dosage of the drug until its complete discontinuation is indicated.

[ 24 ], [ 25 ], [ 26 ]

Interactions with other drugs

In the complex treatment of diseases of the bronchopulmonary system, patients are prescribed drugs of various pharmacological groups. In order for the therapy to be not only effective but also safe, the possibility of interaction of all medications should be taken into account.

Since the metabolism of the active components of Pulmicort is associated with the enzyme CYP3A4, the use of such drugs as Ketoconazole, Itraconazole, HIV protease inhibitors and other CYP3A4 inhibitors may cause an increase in the systemic exposure of budesonide. To prevent adverse reactions, medications should be taken at long intervals or the dosage of GCS should be reduced to the minimum therapeutic values.

An increased effect of corticosteroids and an increase in plasma concentrations of budesonide are observed in women taking oral contraceptives or estrogens. In patients with impaired liver function, the rate of elimination of the drug decreases and there is a risk of developing high systemic exposure. When prescribing Pulmicort after prolonged therapy with oral steroids, muscle and joint pain, allergic reactions are possible.

[ 27 ]

Storage conditions

According to the instructions, all forms of inhaled glucocorticosteroid should be stored in the original packaging. The drug should be protected from sunlight and moisture, inaccessible to children. The optimal storage temperature is no higher than 30 °C. After each use of the inhaler, it should be closed with a protective cap.

Shelf life

Pulmicort must be used within 2 years from the date of manufacture. After opening the foil package, the shelf life of the drug is 3 months. Opened containers with suspension must be used within 12 hours.

The metered dose inhaler in a bottle can be used for 24 months, provided that the storage conditions are met.

Reviews

Numerous positive reviews on the use of Pulmicort for inhalation in the treatment of bronchopulmonary diseases confirm the effectiveness of this drug. Despite the fact that glucocorticosteroid is a hormonal drug, when used correctly, it is safe for both children and adults.

Patients also note that the drug is effective in the treatment of acute and chronic diseases. And if you start using it immediately after diagnosis, the recovery process is much faster and easier. GCS can be combined with other drugs, provided that they interact normally.

[ 28 ]