Salmeter

A drug that has a bronchodilator effect and belongs to the pharmacological group of beta-adrenergic agonists is the innovative drug Salmeter. Its international name is salmeterol. It is about it and its medicinal properties that will be discussed in this article.

It is very hard to watch when a disease, such as bronchial asthma, causes many unpleasant minutes and hours to relatives and close people. It does not spare even small children. Until recently, such patients had to adjust the rhythm of their lives to the disease, which significantly limited them in many things.

Today, modern pharmacological drugs allow not only to effectively relieve attacks, but also, when following a preventive schedule of taking medication, such as Salmeter, a person is able to feel the fullness of life, preventing the development of bronchospasm. It should only be remembered that you should not prescribe medication to yourself and use it thoughtlessly. This approach to stopping the problem can develop into severe, sometimes irreversible, complications. Only a qualified specialist can correctly determine the diagnosis and prescribe effective treatment, which, if thoroughly followed, will lead to a full recovery or long-term remission of the disease.

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Indications Salmeter

Based on its pharmacological characteristics, indications for the use of Salmeter are limited to the following pathological disorders affecting the human body:

1. Preventive measures to relieve asthma attacks of any genesis, be it asthma attacks at night or after even minor physical exertion.
2. Curative and maintenance therapy in patients with a history of chronic obstructive bronchitis.
3. Stopping the process of acute bronchitis.
4. Treatment of other respiratory pathologies, the concomitant manifestation of which is bronchial obstruction (respiratory failure resulting from obstruction of the bronchial tree).
5. Pulmonary emphysema.
6. Prevention of attacks of bronchial asthma, the provoking factor for which is exposure to any allergen.
7. For young patients, this is a permanent therapy for reversible airway obstruction, which occurs if the child has a history of bronchial asthma.

It is necessary to draw the attention of respondents to the fact that Salmeter does not belong to the medicines that are used as a medicine in providing first aid in the event of an attack of bronchial spasm.

Release form

The pharmacological characteristics of Salmeter are quite narrow. Its release form is not very diverse either. On the shelves of pharmacies you can find this drug as a metered aerosol used for inhalation, and the medicine is also available in the form of a white (or slightly yellowish) powder, which is also used as a drug for irrigation of the oral cavity and upper respiratory tract.

The released inhaler, with the medicine filled in, is an aluminum canister, which is equipped with a dosing cap on top. This cap has several functions: it is a protector, a dispenser and, having a spout - a nozzle, which sprays the medicine inside.

One press of the valve is one dose of salmeterol, which is 25 mcg of the active ingredient.

The composition of the drug also includes auxiliary chemical compounds that improve the pharmacodynamics of the drug - these are trichlorofluoromethane, difluorodichloromethane and lecithin.

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Pharmacodynamics

The drug in question belongs to the pharmacotherapeutic group of selective b ₂ -adrenoreceptor agonists. Hence, the pharmacodynamics of Salmeter is determined by its main characteristic - long-term improvement of the bronchial tree patency, which allows to increase the functional capabilities of the lung tissues that support normal bronchodilation (stretching, expansion of the passage channels), which, when taking two doses (50 mcg), is stably maintained for 12 hours after the irrigation procedure. Salmeterol also has anti-inflammatory properties, which are in demand for the diseases listed above.

Salmeter effectively inhibits the permeability of plasma proteins provoked by histamines, which overcome the walls of blood vessels. Taking the medicine allows inhibiting the release, which causes inflammatory processes in the lungs. Relaxation of the smooth muscles of the respiratory organs also occurs, reducing their reactivity, which is the main criterion for the bronchodilator effect. Salmeterol inhibits the production of prostaglandin D ₂ and mast cell leukotrienes.

The prolonged action of the drug in question allows Salmeter to be used as a preventative measure to ensure normal sleep (in the nocturnal form of bronchial asthma) or as a means of preventing the development of an attack of bronchospasm that occurs during physical exertion, which significantly improves the quality of life of an asthmatic.

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Pharmacokinetics

In case of taking a dosage of the drug in the amount of 50 mcg, the maximum therapeutic effect is observed mainly three to four hours after inhalation. The pharmacokinetics of Salmeter is due to bronchodilation, which occurs later than in the case of using the active substance salbutamol, but the duration of its therapeutic effectiveness is much longer and averages about 17.5 hours.

Salmeter, like other drugs of this pharmacological group, when taken in large doses (from 0.2 to 0.4 mg) is capable of affecting the organs of the cardiovascular system, irritating bronchial b2 _- adrenergic receptors.

When using salmeterol at a dosage of 50 mcg twice a day, the maximum amount of the active substance in the blood (C _max ) is 200 pg / ml. This concentration in the plasma is maintained for 5 - 15 minutes. After reaching the maximum, its concentration then begins to decrease sharply.

The drug is metabolized in the patient's body into a hydroxylated metabolite. Most of the drug is eliminated from the body within three days after inhalation. About 25% is excreted through the kidneys with urine, while 60% is excreted with feces, and a small amount is excreted with bile.

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Dosing and administration

Depending on the nature, severity and type of bronchial asthma, the attending physician prescribes the method of administration and dosage of the medication.

For patients diagnosed with bronchial asthma, which bothers a person mainly at night, the drug Salmeter is prescribed in an amount equal to 50 mcg or 100 mcg, taken twice over 24 hours. Such an inhalation schedule allows normalizing the speed and volumetric component of air passing through the patient's bronchi, which significantly improves the quality of the patient's sleep, minimizing the attacks of suffocation that appear.

If the patient suffers from moderate attacks of bronchodilator spasms or is diagnosed with moderate bronchial asthma, the patient is usually prescribed the recommended dosage, which corresponds to 50 mcg, taken twice a day.

A patient with severe bronchial asthma or a disease aggravated by chronic obstructive bronchitis is prescribed a quantity of Salmeter corresponding to 100 mcg, administered twice a day.

The drug in question is prescribed to small patients only after they reach four years of age in a dosage of 25-50 mcg daily.

To achieve maximum efficiency of the procedure, it is necessary to follow all the recommendations for using the inhaler, as stated in the instructions:

1. If a person is using an inhaler for the first time, it is better to perform the procedure in front of a mirror. This will allow you to assess whether it is being performed correctly. If during the inhalation process, vaporous substances are visible coming out of the corners of the mouth, then the procedure is not being performed correctly. It is necessary to close your lips more tightly and try again.
2. Before the first procedure, you should check the working condition of the inhaler. Remove the protective cap from the bottle and make sure that the mouthpiece - sprayer is not clogged with dirt and dust.
3. Place the aluminum bottle in a vertical position (“upside down”), grasping the can with your palm so that the phalanx of the index finger is on its bottom, and the thumb is located on the top of the cap.
4. Immediately before each inhalation, the bottle should be shaken vigorously.
5. Take a deep breath (but without straining) and exhale as deeply as possible, the exhalation should come from the stomach, but you should not make any special efforts or squeeze the remaining air out of yourself.
6. Place the inhaler spray in your mouth and close your lips around it.
7. We start to perform two actions simultaneously: slowly (this is very important) we start to inhale and at the same time we press on the cap - the dispenser, from where the irrigation with the medicine begins. One press - one dose of Salmeter.
8. Then remove the sprayer mouthpiece from the mouth, close your lips very tightly and hold your breathing for as long as you have the strength to hold your breath. You should try to hold it for at least ten seconds.
9. After this, slowly and without straining, release the air from the lungs.
10. If the specialist in the recommendations prescribed the administration of two doses of the drug at one time, you should wait about a minute and repeat the entire procedure, starting from the third point.
11. After irrigation is completely finished, it is necessary to put protection on the spray nozzle.

The mouthpiece - the nebulizer of the inhalation canister should be regularly washed in warm water. This will help maintain the inhaler in working condition.

1. Remove the protective cap and rinse it in clean water.
2. Do not immerse the metal part of the inhaler in liquid.
3. After treatment with water, the inhaler components should be thoroughly dried. Do not involve electrical appliances in this process.
4. Collect the dried components of the device into the inhaler and put the protective cap back in place.

For patients with a history of renal dysfunction, the amount of the drug administered is determined as recommended and no adjustment is required. There is no need to reduce the dosage for elderly people.

If, against the background of Salmetera treatment, using the recommended protocol, the patient does not feel relief and the onset of therapeutic effectiveness, a drug from the beta-adrenergic agonist group, related to emergency medical care drugs, such as Salbutamol, is usually introduced into the schedule. Instead of drugs of this group, one of the corticosteroids can also be prescribed.

When introducing additional drugs, it becomes necessary to adjust the therapeutic doses of both drugs.

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Use Salmeter during pregnancy

The period of bearing a child is the happiest and most responsible period of a woman's life. Many expectant mothers at this time try to minimize the intake of medications. And this is right. After all, any drug is a combination of chemical compounds that affect the human body to one degree or another. Such influence is especially dangerous during the period of formation of the organs and systems of the embryo, which occurs in the first trimester of gestation.

The use of Salmeter during pregnancy is permitted only if the expected therapeutic benefit to the woman's health is much greater than the potential risk of pathological changes that can affect the developing fetus.

The same applies to the period of breastfeeding (lactation). If such therapy is necessary for a woman during breastfeeding of her newborn child, it is advisable to transfer the baby to artificial feeding.

During pregnancy, it is advisable to carry out therapeutic treatment with Salmeter with special caution and under the direct supervision of the attending physician.

Contraindications

To date, monitoring of the intake of the drug in question has confirmed minor contraindications to the use of Salmeter. Such deviations include:

1. Increased intolerance of the patient's body to salmeterol or other components of the drug.
2. This drug is also contraindicated for children under four years of age.

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Side effects Salmeter

The dosages recommended in the instructions included with the medicine (50 mcg and 100 mcg), which are taken twice a day, generally do not cause any negative symptoms.

With higher doses or combined administration of the drug in question with Salbutamol, side effects of Salmeter may be observed, which can be expressed by the following symptoms:

The patient's respiratory system may be provoked to develop progressive paradoxical bronchospasm.

Cardiovascular organs are able to react to increased drug administration:

• Pain in the head area.
• Increased intensity of heart rate. But this symptom may not be related to the introduction of Salmeter, perhaps it is a pathology of a different genesis.
• Atrial fibrillation and supraventricular extrasystole, if the patient with bronchial asthma has a history of predisposition to this pathology.

From the gastrointestinal tract, the following can be observed:

• Irritation of the mucous membrane of the oral cavity or pharynx.
• Disruption of taste buds (dysgeusia).
• Nausea.
• A gag reflex may occur.
• Painful symptoms of an abdominal nature.

Symptoms of an allergic nature:

• Hives.
• Rash on the skin and mucous membranes.
• Angioedema.
• Bronchodilator spasm.

The most rare symptoms:

• Tremor of the lower, but mainly upper limbs, which can be successfully eliminated by selecting an adequate dosage and treatment schedule.
• Arthralgia is pain in the joints.
• Instability of the patient's psychological state.
• Muscle tissue cramps.
• Hypokalemia caused by a sharp decrease in the amount of potassium contained in the patient's blood serum.

If such symptoms appear, you should immediately notify your attending physician, who will prescribe treatment depending on the symptomatic manifestations. Perhaps, to eliminate the pathological symptoms, it will be sufficient to adjust the amount of the administered drug - Salmeter.

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Overdose

If for any reason the doses of the administered medication were exceeded, or due to the individual characteristics of the human body, an overdose of the active ingredient Salmetera may occur.

This pathological process manifests itself with the following symptoms:

1. Tremor of the lower, but to a greater extent, upper limbs.
2. Increased heart rate.
3. Muscle tissue cramps.
4. Pain symptoms affecting the head.
5. A sharp decrease in blood pressure.
6. Heart rhythm disturbance.
7. Nausea.
8. Attacks of vomiting may occur.
9. Hypokalemia is a decrease in the level of an element such as potassium in the blood serum.
10. Hyperkalemia is a condition in which the concentration of potassium in plasma exceeds 5 mmol/L.
11. Acidosis is a condition in which the body produces too many acidic waste products and the kidneys do not fully remove them.

Depending on the pathological symptoms, medical therapy is reduced to symptomatic treatment. Cardioselective β-adrenoblockers are administered with great caution.

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Interactions with other drugs

If, in the light of the disease relief, treatment is carried out with one drug, then it is necessary to clearly know the pharmacodynamic characteristics of the drug used. But if the drug is introduced into complex therapy, the specialist must know how certain drugs mutually affect each other. After all, ignorance of the results of the joint introduction of various combinations of drugs can lead to irreversible pathological consequences.

Interactions of Salmeter with other drugs depend on the group to which the drug - partner belongs. For example, in tandem with xanthine derivatives, the risk of developing hypokalemia in a sick patient increases. A similar result can be expected with the simultaneous administration of salmeterol and glucocorticoids. This outcome should be especially expected if a person has exacerbated bronchial asthma, or if hypoxia is present in his anamnesis. With such a clinical picture, there is a need for constant monitoring of the potassium level in the patient's blood.

When used simultaneously with beta-blockers, including cardioselective drugs, antagonism of salmeterol is detected.

Concurrent use of Salmeter and diuretics can provoke hypokalemia. And when working simultaneously with monoamine oxidase inhibitors (MAO), as well as when taking tricyclic antidepressants, one can expect the appearance of negative pathological symptoms affecting the cardiovascular system.

Salmetera works well in combination with cromoglicic acid and inhaled glucocorticosteroids.

When salmeterol is used simultaneously with glucocorticoids, methylxanthines and/or diuretics, the pharmacodynamic characteristics of the latter are weakened.

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Storage conditions

After the treatment therapy has been prescribed and the patient has purchased the necessary medications from the pharmacy, he should definitely familiarize himself with the recommendations given for storing the medication.

If the patient complies with all the points of the requirements given in the instructions attached to the medicine, then one can be sure that the degree of effectiveness of the medicine will remain at a high pharmacological level throughout the entire shelf life of the medicine.

The storage conditions for Salmeter are not much different from the classic set of recommendations:

1. The medicine should be kept in a cool place for the entire period of permitted use, where the room temperature is between +15 and +30 degrees. But this product must be protected from freezing.
2. Keep Salmeter out of the reach of small children.
3. The medicine should not be exposed to direct sunlight, as the can is under pressure and strong heating can lead to depressurization or even an explosion.
4. The aluminum capsule should not be subjected to impacts or breakage. It should be protected from direct fire and heating to high temperatures.
5. Avoid getting the medicine into your eyes.

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Shelf life

When releasing any product to the market, the manufacturer must indicate on the packaging the date when the drug was released. The second number on the packaging indicates the end date, after which the drug in question should not be used in therapeutic treatment.

The expiration date is also indicated, which for Salmeter is two years.

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