Salmeter

A medication that has a bronchodilator effect and belongs to the pharmacological group of beta-adrenomimetics is an innovative preparation of Salmeter. Its international name is salmeterol. It is about him and his medicamental properties that will be discussed in this article.

It is very difficult to see if a disease, for example, such as bronchial asthma, delivers many unpleasant minutes and hours to relatives and close people. It does not spare even young children. Until recently, such patients had to adjust the rhythm of their lives to the disease, than they essentially limited themselves in many things.

To date, modern pharmacological drugs can not only effectively remove seizures, but also in the implementation of a preventive schedule for taking medication, for example, such as Salmeter, a person is able to feel the fullness of life, preventing the development of bronchospasm. It should only be remembered that it is not necessary to use the medication independently and thoughtlessly to use it. This approach to the relief of the problem can develop into severe, sometimes irreversible, complications. Only a qualified specialist is able to correctly determine the diagnosis and prescribe an effective treatment, which, with its thorough implementation, will lead to a full recovery or to a long-term remission of the disease.
 

[1], [2], [3]

Indications Salmeter

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

1. Preventive measures for relief of attacks of asthma of any genesis, whether it be attacks of suffocation at night or after even a little physical exertion.
2. Medical therapy and maintenance therapy in the presence of a history of chronic obstructive bronchitis.
3. Coping the process of acute bronchitis.
4. Treatment of other pathologies of the respiratory tract, concomitant manifestation of which is obstruction of the bronchi (respiratory failure, resulting from impaired patency of the bronchial tree).
5. Emphysema of the lungs.
6. Prevention of attacks of bronchial asthma, provoking factor for which is the effect of an allergen.
7. For small patients, this is a permanent therapy for reversible airway obstruction, which occurs if a child has a history of bronchial asthma.

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

Release form

Pharmacological characteristics of Salmeter are quite narrowly focused. Does not differ a great variety and its form of release. On the shelves of pharmacies you can find this drug as a metered aerosol used for inhalation, as well as the drug is available in the form of a powder of white (or slightly yellowish) hue, which is also used as a preparation for irrigation of the oral cavity and upper respiratory tract.

The produced inhaler, filled with medicine, is a can of aluminum, which is equipped with a dispensing cap on top. This cap has several functions: it is a protection, a dispenser and, having a nozzle - a nozzle, which also sprays the inside of the preparation.

One pressing of the valve is a single dose of salmeterol, which is 25 μg of active substance.

The composition of the drug added and additional chemical compounds that increase the pharmacodynamics of the drug - a trichlorofluoromethane, difluorodichloromethane and lecithin.

[4], [5], [6], [7], [8],

Pharmacodynamics

The drug in question is a pharmacotherapeutic group of selective β ₂ -adrenoceptor agonists. Hence the pharmacodynamics of Salmeter is determined by its main characteristic - the long-term improvement in the patency of the bronchial tree, which makes it possible to increase the functionality of the lung tissues that support normal bronchodilation (stretching, widening of the passageways), which, when taking two doses (50 μg), stays stable for 12 hours after irrigation procedures. Salmeterol also has anti-inflammatory properties, in demand with the diseases listed above.

Salmeter effectively inhibits the histamine-induced permeability of plasma proteins that overcome the walls of blood vessels. Taking medication can inhibit the release, which causes inflammation in the lungs. There is also a relaxation of the smooth muscles of the respiratory organs, reducing their reactivity, which is the main criterion for bronchodilatation. Salmeterol inhibits the production of prostaglandin D ₂ and leukotrienes of mast cells.

Prolongation of the drug in question makes it possible to use Salmeter as a prophylaxis to ensure normal sleep (with nocturnal bronchial asthma) or as a means of preventing the development of an attack of bronchospasm that occurs against the background of physical exertion, which significantly improves the quality of life of asthmatics.

[9], [10], [11]

Pharmacokinetics

If the dosage is taken in the amount of 50 μg, the maximum therapeutic effect is observed, mainly after three to four hours after inhalation. The pharmacokinetics of Salmeter are caused by bronchodilation, which occurs later than with the use of the active substance salbutamol, but the duration of its therapeutic efficacy is much higher and averages about 17.5 hours.

Salmeter, like other drugs of this pharmacological group, when taking large doses (from 0.2 to 0.4 mg) is able to affect the organs of the cardiovascular system, irritating bronchial b ₂ -adrenoreceptors.

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

The drug is metabolized in the body of a patient into a hydroxylated metabolite. Most of the drug is excreted from the body for three days after inhalation. At the same time, about 25% is utilized through the kidneys along with the urine, while 60 percent leaves the body with fecal masses, a small amount is disposed of with bile.

[12], [13],

Dosing and administration

Depending on the nature, severity and type of bronchial asthma, the treating doctor prescribes the way of application and the dose of the medicine.

In patients who have been diagnosed with bronchial asthma, which persists a person mainly at night, Salmeter is prescribed in an amount equal to 50 μg or 100 μg, taken twice for 24 hours. This schedule of inhalations allows to normalize the speed and volume component of the air passing through the patient's bronchi, which significantly improves the quality of sleep of the patient, minimizing the appearing attacks of suffocation.

If the patient suffers from moderate attacks of bronchodilator spasms or is diagnosed with moderate bronchial asthma, the patient is usually given a recommended dosage corresponding to 50 μg taken twice a day.

A patient with a severe degree of bronchial asthma or a condition burdened with obstructive bronchitis of a chronic nature is given an amount of Salmeter corresponding to 100 μg administered twice a day.

In small patients, the drug in question is attributed only after reaching a four-year age in a dosage of 25-50 μg daily.

In order to get maximum effectiveness of the performed procedure, it is necessary to follow all recommendations for the use of the inhaler, which are stated in the instructions:

1. If a person uses an inhaler for the first time, it is better to perform the procedure before the mirror for the first time. This allows to assess the correctness of its implementation. If during the inhalation process, the vaporous substances released from the corners of the mouth are visible, therefore, the procedure is not carried out correctly. It is necessary to close your lips tight and try again.
2. Before the first procedure, you should check the operating status 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. Aluminum bottle put in a vertical position ("upside down"), wrapping the balloon with the palm so that the phalanx of the index finger was on its bottom, and the thumb is located on the top of the cap.
4. Immediately before each inhalation inhalation, flacon should be vigorously shaken.
5. Make a breath in full breast (but without tension) and as much as possible to exhale, exhalation should go as if from the stomach, but make special efforts and squeeze out the remaining air should not.
6. The nebulizer of the inhaler is placed in the mouth and clamped with his lips.
7. We start simultaneously to make two actions: slowly (this is very important) we begin to inhale and in parallel we press on the cap - the dispenser, where the irrigation begins with the drug. One push is a single dose of Salmeter.
8. Then the mouthpiece of the nebulizer is withdrawn from the mouth, tightly closed lips and holds the breathing process as long as the force does not breathe. You should try to hold out for at least ten seconds.
9. After that, slowly, without straining, to release air from the lungs.
10. If the expert recommends two doses of the drug once in the recommendations, wait about a minute and repeat the whole procedure starting from the third paragraph.
11. After the irrigation is completely finished, it is necessary to put the protection on the nozzle - spraying.

Mouthpiece - the nebulizer of the inhalation canister should be washed regularly in warm water. This will make it possible to maintain the inhaler in working order.

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

Patients who have a history of kidney dysfunction, the amount of medication administered is determined as recommended and no correction is required. There is no need to reduce dosage and elderly people.

If, against the background of Salmeter's therapy with the use of the recommended protocol, the patient does not feel any relief and the onset of therapeutic efficacy, the drug group of beta-adrenomimetics, related to emergency medicine, for example, Salbutamol, is usually introduced into the schedule. Instead of drugs in this group, one of the corticosteroids may also be prescribed.

With the introduction of additional drugs, it becomes necessary to adjust the therapeutic doses of both drugs. 

[19]

Use Salmeter during pregnancy

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

The use of Salmeter during pregnancy is allowed only if the perceived therapeutic effectiveness for a woman's health is much more significant 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 the feeding of her newborn child with mother's milk, it is advisable to transfer the baby to artificial feeding.

During pregnancy, it is desirable with special care and under the direct supervision of the treating doctor to conduct therapeutic treatment with Salmeter.

Contraindications

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

1. Increased intolerance to the organism of the patient to salmeterol or other components of the medicine.
2. Contraindicated in taking this drug and children who are not yet four years old.

[14], [15]

Side effects Salmeter

Recommended dosages (50 mcg and 100 mcg), which are taken twice a day during the day, do not cause any negative symptoms.

With higher amounts of input or co-administration of the drug in question with Salbutamol, there may be side effects of Salmeter, which can be expressed by such symptoms:

The respiratory system of the patient's body can be provoked by the appearance of progressive paradoxical bronchospasm.

The organs of the cardiovascular system are able to respond to the increased injection of the drug:

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

From the gastrointestinal tract can be observed:

• Irritation of the mucous membrane of the mouth or pharynx.
• Disturbance in the work of taste buds (dysgeusia).
• Nausea.
• There may be emetic reflections.
• Pain symptomatology of abdominal character.

Symptoms of an allergic nature:

• Hives.
• Rashes on skin and mucosal surface.
• Angioedema.
• Broncholytic spasm.

The most common symptomatology is:

• The tremor of the lower but mostly upper limbs, which can be safely eliminated by the selection of an adequate dosage and treatment schedule.
• Arthralgia - pain in the joints.
• Instability of the patient's psychological state.
• Cramps of muscle tissue.
• Hypokalemia, caused by a sharp decrease in the amount of potassium contained in the serum of the patient.

When such symptoms appear, you should immediately notify your doctor who, depending on the symptomatic manifestations, will prescribe the treatment. Perhaps to correct pathological symptoms it will be sufficient to adjust the amount of medication administered - Salmeter.

[16], [17], [18]

Overdose

If, for some reason, the doses of the drug administered have been exceeded, or because of the individual characteristics of the human body, an overdose of the active substance of Salmeter may occur.

This pathological process manifests itself by a similar symptomatology:

1. The tremor is lower, but, to a greater degree, upper limbs.
2. Cardiopalmus.
3. Cramps of muscle tissue.
4. Pain symptomatology affecting the head.
5. A sharp decrease in blood pressure.
6. Failure in the work of the heart rate.
7. Nausea.
8. There may be attacks of vomiting.
9. Hypokalemia is a decrease in serum levels of an element such as potassium.
10. Hyperkalemia is a condition in which the potassium concentration in the plasma exceeds 5 mmol / l.
11. Acidosis is a condition when the body produces too much acidic metabolic products, and the kidneys do not fully take them out.

Therapeutic therapy is reduced, depending on the pathological symptomatology, to symptomatic treatment. With great care, cardioselective β - adrenoblockers are introduced.

[20], [21],

Interactions with other drugs

If in the light of arresting the disease, one drug is treated, then it is necessary to clearly know the pharmacodynamic characteristics of the drug used. But if the drug is injected into a complex therapy, the specialist must necessarily know how each other drugs influence one another. In fact, ignorance of the results of the joint administration of a different combination of drugs can lead to irreversible pathological consequences.

The interaction of Salmeter with other drugs depends on the group to which the medicinal partner belongs. For example, when tandem with xanthine derivatives, the risk of developing hypokalemia in a patient is increased. A similar result can be expected with simultaneous administration of salmeterol and glucocorticoids. Especially such a finale should be expected if a person has exacerbated bronchial asthma, or if there is hypoxia in his anamnesis. With such a clinical picture, it becomes necessary to constantly monitor the level of potassium in the patient's blood.

With simultaneous use with beta-blockers, including with cardioselective drugs, antagonism of salmeterol is detected.

Parallel application of Salmeter and diuretics can provoke hypokalemia. And with simultaneous work with monoamine oxidase (MAO) inhibitors, as well as in parallel reception with tricyclic antidepressants, one can expect the emergence of negative pathological symptoms that affect the organs of the cardiovascular system.

Salmeter works well together with cromoglycic acid and inhaled glucocorticosteroids.

With the simultaneous use of salmeterol with glucocorticoids, methylxanthines and / or diuretics, there is a weakening of the pharmacodynamic characteristics of the latter.

[22], [23], [24], [25]

Storage conditions

After the treatment is prescribed and the patient acquires the necessary drugs in the pharmacy, he should be sure to get acquainted with the recommendations that are given on the storage of the medicine.

If the patient meets all the points of the requirements given in the instructions attached to the medication, you can be sure that the degree of effectiveness of the drug will remain at a high pharmacological level, throughout the duration of the validity of the drug.

The storage conditions of Salmeter do not differ much from the classic set of recommendations:

1. The medicament must be kept throughout the period of permissible use in a cool place where the room temperature is between +15 and +30 degrees. But this product must be protected from freezing.
2. Keep Salmeter in a place inaccessible to small children.
3. The drug should not be exposed to direct sunlight, as the canister is under pressure and strong heating can lead to depressurization, and even its explosion.
4. Aluminum capsule should not be subjected to shock and breakage. It must be protected from direct fire and heating to high temperatures.
5. Keep out of sight of the medicinal product.

[26], [27], [28]

Shelf life

By releasing any product on the market, the manufacturer company always indicates the date on the packaging when the medicine was released. The second number on the package indicates the end date, after which the drug in question should not be used in therapeutic treatment.

Indicated and expiration date, which for Salemeter is two years.

[29], [30], [31]