Inhalations with pulmicort: is it possible and how much to do?

An effective inhalation drug is Pulmicort. Consider the main indications for its use, dosage, mechanism of action.

The drug belongs to the glucocorticoid. It is used for diseases of the respiratory system. Effective in the treatment of bronchial asthma, as it affects all parts of the pathological process. The active ingredients affect glucocorticosteroid receptors, regulate the synthesis of various substances. The main targets of the drug are genes encoding and inhibiting the synthesis of anti-inflammatory components.

• Blocks the combination of anti-inflammatory and bronchoconstrictor substances.
• Enhances the bronchodilator effect of adrenomimetics and increases the sensitivity of b2-adrenoreceptors.
• Reduces bronchial blood flow and reduces the synthesis of nitric oxide, which stimulates bronchospasms.

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

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

[1]

Indications Pulmicort

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

• Persistent bronchial asthma (if necessary, maintenance therapy with glucocorticosteroids).
• 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 using Pulmicort are:

• Protracted cough of unknown etiology.
• Larengotraheit.
• Faringit.
• Laryngit.
• Rhinitis of various etiologies.
• Pulmonary pathology, emphysema.

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

Pulmicort for inhalation with bronchitis

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

Bronchitis is an acute, usually infectious disease affecting the bronchial mucosa. Most often it is a complication of influenza or ARVI, therefore it has a seasonal nature. In some cases, bronchitis occurs due to chemical or physical factors. The disease duration is about 2-3 weeks. Bronchitis is acute and chronic. The latter is classified by morphology, functional impairment, course and the presence of complications.

Pulmicort for inhalation with bronchitis has such an effect on the lesion:

• Anti-inflammatory.
• Antiedematous.
• Immunosuppressive.
• Antiallergic.

The drug eliminates bronchospasms, reduces the amount of sputum in the bronchial tree and helps to remove it from the body. Inhalation affects directly the bronchial mucosa. The maximum concentration of the active substance is reached in 20-30 minutes after application. Due to this, swelling of the mucous membrane comes down and breathing is restored.

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

In the larynx

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

The feasibility of using Pulmicort for inhalation with laryngitis is explained by its properties:

• Antianaphylactic.
• Antispasmodic.
• Antiedematous.
• Anti-inflammatory.

The drug reduces swelling of the mucous membrane of the larynx, suppresses local allergic reactions and relaxes the smooth muscles of the respiratory tract. The active component inhibits the synthesis of pro-inflammatory biologically active compounds. Inhalation agent creates favorable conditions for the further use of bronchodilators.

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

With allergies

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

Hormone remedy is allowed for the treatment of allergies in both children and adults. Nebulizer inhalations are effective for dry allergic cough with viscous sputum. For the procedure, the drug is diluted with saline or combined with the intake of antihistamines.

Pulmicort for inhalation with 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 to relieve cough attacks is inhalation with Pulmicort.

The drug is effective in such diseases:

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

The drug includes budesonide. The active ingredient has anti-inflammatory and anti-allergic properties. With the help of inhalation, the active component acts on the mucosa of the respiratory tract, relieving its irritation.

Inhalation should be carried out only by doctor's prescription. This is due to the fact that the drug has a number of contraindications: stage 3-4 pulmonary tuberculosis, skin viral infections, intolerance to the active components of the drug, kidney disease. You should also consider the risk of adverse reactions with incorrect dosage of the drug or its long-term use.

[2], [3]

Pulmicort for inhalation with adenoids

Adenoids are a proliferation of the pharyngeal tonsil, which provokes its inflammation. Inhalation with adenoiditis is aimed at reducing the growth rate of adenoids and reducing painful symptoms.

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

• Reduce swelling of the mucous.
• Warn and stop inflammatory processes.
• They improve the flow of lymph and blood.
• Strengthen local immunity.
• Stop coughing episodes.
• Moisturize dry mucous membrane.
• Liquefy sputum and reduce the intensity of a cold.
• Prevent the development of such complications: pharyngitis, tracheitis, laryngitis.

Inhalation with pulmicort with adenoids is primarily aimed at relieving symptoms of inflammation of the pharyngeal tonsil. Medical procedures are carried out through a nebulizer. In this case, inhalation is not recommended for patients with frequent bronchospasms, a tendency to nasal bleeding. If the adenoids in stage 2-3, the effect of inhalation will be insignificant. In this case, the main method of therapy is surgery.

[4], [5], [6]

At a 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 inhalation 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. Active substances do not penetrate into the systemic circulation and do not affect the functioning of the internal organs.

If the temperature jumped after the use of a nebulizer, then it is quite possible that this is the result of the action of the drug. In this case, you should consult with your doctor to prevent complications. If the increased temperature is accompanied by vomiting, then inhalation is not carried out. Also contraindications include intolerance to the components of Pulmicort.

[7]

Release form

Pulmicort has several forms of release, which allows you to choose the most convenient way to use the medicine.

• Powder inhaler with dispenser. Contains the round, crushed in fine powder granules. A powder fraction may be present in the aerosol. The inhaler is designed for 100 and 200 doses.

• Suspension for inhalation through a nebulizer in containers of 2 ml, 20 nebul in the package.

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

[8]

Pulmicort 0.25 and 0.5

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

[9], [10]

Suspension

Dosed suspension for inhalation contains the active ingredient - budesonide micronized 0.25 mg or 0.5 mg. Substance easily resuspended sterile, white.

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

[11], [12], [13]

Solution for inhalation

To carry out inhalation using a nebulizer using Pulmicort solution (suspension). The drug is available in disposable polyethylene containers of 2 ml. The solution for inhalation is effective in such cases:

• Coughing attacks of various origins.
• Allergic reactions with anaphylaxis.
• Bronchitis.
• Laryngit.
• Bronchial asthma.
• HABL.
• Rhinitis.

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

If several drugs are prescribed for inhalation, then bronchodilators are used primarily, 10–15 minutes later mucolytics and anti-inflammatory drugs after sputum discharge.

Powder for inhalation

Pulmicort Turbuhaler is a powder form of the drug used for inhalation. The drug is available in plastic bottles of 100 µg / dose and 200 µg / dose. The inhaler consists of a metering device, a container for storing powder and desiccant, a mouthpiece and a lid. It is convenient to carry a turbuhaler with itself and to apply as required.

[14]

Inhalation drops Pulmicort

Inhalation drug for the treatment of obstructive diseases of the upper respiratory tract has several forms of release and dosage. One of them is a suspension in special disposable bottles. Therapeutic procedures are performed using a nebulizer.

Drops for inhalation mixed with saline in the proportions prescribed by the doctor. Pulmicort has a local effect on mucous membranes. It has pronounced anti-inflammatory and anti-allergic properties. Persistent clinical effect develops within 5-7 days of course use of the drug.

Pharmacodynamics

Pulmicort is included in the pharmacological group of glucocorticosteroids, therefore it has a complex effect on the body:

• Anti-inflammatory.
• Pain reliever
• Antiallergic.

The drug is used inhalation, therefore, primarily has an anti-inflammatory effect. Active ingredients reduce the swelling of the bronchial mucosa, blocking cells that secrete mediators of allergic reactions. This reduces the bronchial blood flow and the synthesis of nitric oxide, stimulating bronchospasm.

The mechanism of action of the drug is similar to glucocorticoid receptors. Pulmicort has a low lyophilicity and high penetrating ability relative to the tissues of the lungs. Anti-anaphylactic 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 ingredients. The preparation contains budesonide - corticosteroids with a pronounced anti-inflammatory effect. Inhibits the release of inflammatory 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 of pulmonary function occurs within 2 days from the start of therapy and persists for about 4 weeks.

[15], [16]

Pharmacokinetics

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

Pharmacokinetics Pulmicort is proportional to its dose relative to the accepted dosage. The active substance undergoes a significant metabolism in the liver at the first passage. Metabolites have a low glucocorticosteroid activity. Excreted in the urine unchanged or conjugated. In urine can be determined by a small amount of unchanged budesonide.

[17], [18], [19], [20], [21]

Dosing and administration

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

The main indications for use Pulmicort for inhalation in adults:

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

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

Inhalation for adults can be performed using a nebulizer, diluting Pulmicort with saline. Also well proven metered inhaler turbuhaler. The duration of therapy and the required dosage should be established by the attending physician, since this GCS is a prescription drug.

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

When using the Pulmicort Turbuhaler, you must follow these rules:

• Clearly adhere to the dosage prescribed by the doctor.
• Inhale strongly and deeply through the nozzle, ensuring that the optimal dose of the drug is inhaled into the airways.
• Do not exhale through the nozzle.
• After the procedure, close the inhaler cap.
• Rinse your mouth with water after each inhalation to reduce the risk of developing oral candidiasis.

In chronic obstructive pulmonary disease, the recommended dose is 400 micrograms 2 times a day. After inhalation of a single dose, the therapeutic effect develops incrementally 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 applications.

In severe cases, the dosage can be increased to 1600 mcg. With maintenance therapy, the dose should be as low as possible.

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

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

On average, inhalation using a nebulizer lasts from 5 to 10 minutes or until the solution in the apparatus is complete. A lasting therapeutic effect is achieved after 5-7 days of regular use of the drug.

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

[23]

Pulmicort for inhalations for children

Despite the fact that Pulmicort is a hormonal drug, it is prescribed to treat not only adults, but also children older than 6 months. The main indications for inhalation with SCS are:

• Chronic obstructive pulmonary disease.
• Asthma of various etiologies.
• Infectious lesions of the upper respiratory tract.
• Faringitis, neuropathy.
• Cough dry, wet.
• Prevention of nasal polyps.
• Hypersensitivity to allergens.

The drug has proven itself as a means of emergency aid in bronchial asthma, laryngitis, laryngotracheitis and other conditions in which the respiratory process is disturbed due to swelling of the mucous membrane.

Inhalation is carried out using a nebulizer. The device disperses the drug on the dispersed particles that are inhaled through a tube or mask and enter the respiratory organs. For the procedure using the suspension, diluting it with 0.9% sodium chloride solution. The initial dosage is from 0.25 to 0.5 mg per day. In severe cases, the doctor may increase the dose to 1 mg.

Before using the drug, it should be borne in mind that it has a number of contraindications: age less than 6 months of life, hypersensitivity to drug components, pulmonary tuberculosis of 3, 4 degrees. If used incorrectly or if the prescribed dosage is exceeded, there is a risk of adverse reactions: oral stomatitis, dry mouth, urticaria, anxiety, decreased adrenal function, and more.

[24]

Use Pulmicort during pregnancy

The use of inhaled glucocorticosteroid 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 conducted studies did not reveal any abnormalities in the development of the child during treatment with budesonide. After birth, it is necessary to control the function of the adrenal glands of the newborn.

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

Contraindications

Synthetic glucocorticosteroid has a number of contraindications that should be considered before using it:

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

With extreme caution, the drug is prescribed for patients with active / inactive form of pulmonary tuberculosis, cirrhosis of the liver, with fungal, viral and bacterial diseases of the respiratory organs, as well as during pregnancy and lactation.

Side effects Pulmicort

As a rule, Pulmicort does not cause adverse reactions, but in some cases the development of such symptoms is possible:

• Candida oropharyngeal lesion.
• Irritation of the mucous membranes of the respiratory tract.
• Cough and dry mouth.
• Nervousness and irritability.
• Blurred consciousness.
• Hypofunction of the adrenal cortex.
• Various allergic reactions.

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

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

Overdose

With a one-time excess of the doses prescribed by a doctor by inhalation GCS, the symptoms of overdose have no clinical manifestations. In the case of chronic overdose, hypercorticism and adrenal suppression develop:

• Arterial hypertension.
• Muscle weakness.
• Amenorrhea.
• Weight gain
• Streaks.

For treatment, a gradual decrease in the dosage of the drug until it is completely withdrawn is shown.

[25], [26], [27],

Interactions with other drugs

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

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

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

[28]

Storage conditions

According to the instructions, all forms of release 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 not higher than 30 ° C. After each use, the inhaler should be closed with a protective cap.

Shelf life

Pulmicort must be used within 2 years from the date of its production. After opening the foil packet, the shelf life of the drug is 3 months. Open suspension containers must be used within 12 hours.

The dosed inhaler in the vial can be applied for 24 months, provided that the conditions for its storage are observed.

Reviews

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

Also, patients note that the drug is effective in the treatment of acute and chronic diseases. And if you begin to use it immediately after the diagnosis, the healing process is much faster and easier. GCS can be combined with other drugs, provided that they interact normally.

[29],