Nebutamol

Nebutamol is an anti-asthmatic drug. It belongs to the group of selective β2-adrenergic receptor agonists.

Indications Nebutamol

It is used to treat asthma attacks, and also in the treatment of people with chronic obstructive pulmonary pathologies.

Release form

The product is produced in the form of a liquid for nasal inhalation, in disposable containers with a capacity of 2 or 2.5 ml. A separate polymer package contains 10 such containers; a box contains 4 such packages.

Pharmacodynamics

Salbutamol is the active ingredient of the drug. In medicinal doses, it affects β2-adrenoreceptors in the bronchial musculature. At the same time, the effect on cardiac β1-adrenoreceptors is minimal or absent.

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Pharmacokinetics

When a drug is administered by inhalation, about 10-20% of the dose enters the lower part of the respiratory tract. The rest of the dose remains in the oropharynx, where it is swallowed with saliva. The portion of the dose that enters the respiratory system is absorbed into the lung tissue and penetrates into the circulatory system; no metabolism of the substance occurs inside the lungs.

The medication begins to act 4-5 minutes after the inhalation procedure, and the duration of the therapeutic effect is within 4-6 hours.

Once inside the circulatory system, the substance undergoes hepatic metabolism and is then excreted unchanged and as a phenol sulfate metabolic product through the kidneys (primarily).

Part of the drug that enters the digestive tract through the nasopharynx is absorbed inside the gastrointestinal tract, undergoes first liver passage, is converted into a phenol sulfate compound, and is then excreted through the kidneys.

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Dosing and administration

The medication is administered through inhalation - the substance is inhaled through the mouth using a special nebulizer. The therapy should be carried out under medical supervision. The medicinal solution can also be swallowed orally or administered by injection.

Scheme of use for children and adults (this includes elderly patients).

At first, a dose of 2-2.5 mg is usually used for inhalations. Later, it can be increased to 4-5 mg. Inhalation procedures are allowed to be carried out 4 times a day.

In the treatment of people with severe respiratory tract obstruction, a dose increased to 40 mg per day is used, but such a regimen can only be used in a hospital under medical supervision.

Because transient hypoxemia may develop, the possible need for supplemental oxygen therapy should be taken into account.

Nebutamol is often used undiluted, although in cases where inhalation must continue for quite a long time (more than 10 minutes), the liquid contained in the container is diluted with sterile saline.

Inhalation of the medicinal aerosol can be performed using a special face mask or mouthpiece. Periodic ventilation is required in rooms where inhalation procedures are performed. If the likelihood of hypoxia due to hypoventilation increases, the person inhaling the medicine will require oxygen therapy.

Only a doctor can increase the portion size and frequency of procedures, taking into account the likelihood of developing negative effects associated with an increase in dosage.

Scheme of use of the medicinal product.

First, you need to prepare a special nebulizer for use. Then you need to open the package with containers and take one of them out. You can open the package and take the containers out only before inhalation. Then shake the container, after which you carefully open it.

The opened container is inserted into the nebulizer with the open end, after which it is pressed lightly. It is necessary to make sure that all the liquid from the container has been poured into the nebulizer.

After the procedure, the nebulizer is rinsed with water, and the remaining unused portion of the dosage must be disposed of.

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Use Nebutamol during pregnancy

During pregnancy, salbutamol is used only in situations where the potential benefit to the woman outweighs the risk of complications to the fetus.

Because salbutamol can be excreted in breast milk, it should not be used during breastfeeding.

Contraindications

It is contraindicated to use the medication if there is a history of intolerance to any element of the drug. Although salbutamol in the form of an injection liquid, and sometimes in the form of suppositories or tablets, is used during premature birth, the same substance in the form of an inhalation aerosol is prohibited in these situations. In addition, salbutamol is not prescribed if there is a risk of miscarriage.

Side effects Nebutamol

The use of an aerosol may provoke the development of certain side effects:

• immune disorders: symptoms of intolerance appear sporadically, including urticaria, Quincke's edema, orthostatic collapse, decreased blood pressure and bronchospasm;
• metabolic problems: hypokalemia may occasionally develop. Potentially severe hypokalemia may develop as a result of β2-adrenergic receptor use. Lactic acidosis may occasionally occur in people with acute asthma who use intravenous or nebulized salbutamol;
• disorders of the nervous system function: headaches or tremors often occur. Hyperactivity is occasionally observed;
• lesions affecting the functioning of the cardiovascular system: tachycardia often occurs. Heart rhythm disorders are observed sporadically, including ventricular fibrillation, extrasystole with supraventricular tachycardia, and peripheral vasodilation. Myocardial ischemia may develop;
• respiratory duct disorders: paradoxical bronchial spasms occur sporadically. As with other inhalation medications, a similar disorder may occur, which also increases suffocation. In these situations, immediate discontinuation of the medication and subsequent administration of analogs or other fast-acting inhalation bronchodilators are required;
• symptoms from the digestive system: occasionally irritation of the oral and pharyngeal mucosa occurs;
• lesions affecting the musculoskeletal structure: sometimes cramps occur in the muscle area.

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Overdose

Most often, Nebutamol poisoning causes transient changes caused by the therapeutic effect of β-adrenergic receptors (including tremor with tachycardia and headaches). Salbutamol intoxication can provoke hypokalemia, which requires regular monitoring of serum potassium levels.

To eliminate such disorders, it is necessary to stop the use of salbutamol and to start the necessary symptomatic procedures. It is necessary to prescribe cardioselective β-blockers for therapy in people with cardiac signs (for example, increased heart rate or tachycardia).

It should be taken into account that drugs from the β-blocker category are prescribed with extreme caution to individuals with a history of bronchial spasms.

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Interactions with other drugs

Salbutamol is prohibited to be used in combination with non-selective β-blockers, including, for example, propranolol.

Salbutamol may be prescribed to individuals using drugs that inhibit MAO activity.

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Storage conditions

Nebutamol should be kept in a dark place, out of reach of small children. It is prohibited to freeze the solution. Temperature values are up to 25°C.

Shelf life

Nebutamol can be used within 36 months from the date of release of the therapeutic agent. An opened polymer package has a shelf life of 90 days.

Application for children

There is no data on the therapeutic efficacy of using the drug in infants under 1.5 years of age, which is why it is not prescribed to this age group.

Analogues

Analogues of the drug are the drugs Ventilor, Salbuvent, Salbutamol-Neo, as well as Ventolin Evohaler, Salbutamol with Ventolin nebules, Salbutamol sulfate and Salbutamol-Intelli.