Nebutamol

Nebutamol is an anti-asthmatic medicine. It is included in the group of selective agonists of β2-adrenergic receptors.

Indications Nebutamol

It is used to treat asthma attacks, and in addition, when treating people with pulmonary obstructive pathologies that have a chronic form.

Release form

The release is made in the form of a liquid for nasal inhalations, in disposable containers of 2 or 2.5 ml capacity. Inside a separate polymer package there are 10 such containers; in a box there are 4 such packages.

Pharmacodynamics

Salbutamol is an active element of the drug. In drug doses, it affects β2-adrenergic receptors in the musculature of the bronchi. In this case, the effect on cardiac β1-adrenergic receptors is minimal or completely absent.

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Pharmacokinetics

When you inject drugs through inhalation, about 10-20% of the portion falls into the lower part of the respiratory ducts. The rest of the dosage remains in the area of the oropharynx, where it is swallowed with saliva. That portion of the portion that has entered the respiratory system is absorbed into the lung tissue and enters the circulatory system; metabolism of the substance inside the lungs does not occur.

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

The substance that enters the circulatory system undergoes hepatic metabolism, and then is excreted unchanged and as a phenol-sulfate metabolic product through the kidneys (mostly).

Part of the medicine, which got inside the digestive tract through the nasopharynx, is absorbed inside the gastrointestinal tract, undergoes the first hepatic passage, converting to a phenol-sulfate compound, and then excreted through the kidneys.

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

Dosing and administration

The medication is injected through inhalations - the substance is inhaled through the mouth using a special nebulizer. Therapy should be carried out under medical supervision. Also, the drug solution can be ingested orally or injected.

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

First, a portion of 2-2.5 mg is usually used for inhalations. Later it can be increased to 4-5 mg. Inhalation procedures may be performed 4 times a day.

In therapy in people with obstruction of the respiratory ducts, a high dose of 40 mg per day is used heavily, but this scheme can be used only in a hospital under medical supervision.

In connection with the fact that transient hypoxemia can develop, it is necessary to take into account the possible need for additional oxygen treatment.

Neutobamol is often used undiluted, although in cases where inhalation should last for quite some time (more than 10 minutes), the liquid contained in the container is diluted with sterile saline solution.

Inhaling therapeutic aerosol can be performed using a special face mask or mouthpiece. In rooms where inhalation procedures are performed, periodic ventilation is required. With an increase in the likelihood of hypoxia due to hypoventilation in a person inhaling the drug, he needs oxygen therapy.

Increase the size of the portion and the frequency of procedures can only doctor who, in doing so, takes into account the likelihood of developing adverse effects associated with an increase in dosage.

Scheme of use of medicament.

First, a special nebulizer should be prepared for use. Next, you need to open a package with containers and extract one of them from there. It is possible to open the package and get out containers only before carrying out inhalations. Then the container is shaken, after which it is opened gently.

Open the container with an open edge inserted into the nebulizer, then lightly press it. You need to make sure that all the liquid from the container has been transferred to a nebulizer.

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

[10]

Use Nebutamol during pregnancy

In pregnancy, salbutamol is used only in situations where the likely benefit for a woman is more expected than the risk of complications in the fetus.

Because salbutamol is excreted with breast milk, it can not be used during periods of breastfeeding.

Contraindications

It is contraindicated to use a medicine in the presence of an anamnesis of intolerance in relation to any element of drugs. While salbutamol in the form of an injection liquid, and sometimes in the form of suppositories or tablets, is used during premature births, it is forbidden to prescribe the same substance in the form of an inhalation aerosol in these situations. In addition, salbutamol is not prescribed if there is a threat of miscarriage.

Side effects Nebutamol

The use of aerosol can provoke the development of certain side effects:

• immune disorders: single symptoms of intolerance appear, among them urticaria, Quincke edema, orthostatic collapse, lowering of blood pressure and spasm of the bronchi;
• problems with metabolic processes: hypokalemia develops occasionally. As a result of the use of β2-adrenergic receptors, a potentially severe degree of hypokalemia can develop. In people with exacerbated asthma, using salbutamol, used intravenously or with the help of a nebulizer, lactoacidosis can appear lately;
• disorders of the NA function: often there are headaches or tremors. Individual hyperactivity is noted;
• lesions affecting the work of the CAS: often there is a tachycardia. Disorders of the rhythm of the heartbeat are observed, including ventricular fibrillation, extrasystole with supraventricular tachycardia and peripheral vasodilation. Possible development of myocardial ischemia;
• Disturbances in the respiratory duct area: there are rare paradoxical spasms of the bronchi. As with the use of other inhaled medications, a similar disorder can occur, against which background asphyxiation also increases. In these situations, immediate withdrawal of the drug and the subsequent administration of any analogues or other rapid inhaled bronchodilators are required;
• symptoms on the part of the digestive organs: occasionally irritation of oral and pharyngeal mucosa occurs;
• lesions affecting the musculoskeletal structure: sometimes there are cramps in the muscles.

[8], [9]

Overdose

Most often, nebutamol poisoning develops transient changes, caused by the therapeutic effect of β-adrenergic receptors (among them tremor with tachycardia and headaches). Intoxication with salbutamol can provoke hypokalemia, which requires regular monitoring of serum potassium values.

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

It should be borne in mind that drugs from the category of β-blockers are extremely cautiously prescribed to persons with bronchial spasms in the anamnesis.

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Interactions with other drugs

Salbutamol is not allowed in combination with non-selective β-blockers, among which, for example, propranolol.

It is allowed to prescribe salbutamol to people using drugs that slow down MAO activity.

[14], [15]

Storage conditions

Nebutamol is required to be kept in a dark place inaccessible to small children. Do not freeze the solution. The temperature is up to 25 ° C.

Shelf life

Nebutamol can be administered within 36 months of the release of the therapeutic agent. The opened polymer bag has a shelf life of 90 days.

Application for children

There is no data on the therapeutic effectiveness of the use of drugs to infants under 1.5 years, which is why this age group is not assigned to it.

Analogues

Analogues of the medication are preparations Ventolor, Salvobent, Salbutamol-Neo, and in addition Ventolin Evohaler, Salbutamol with Ventolinom nebula, Salbutamol Sulphate and Salbutamol-Inteli.