Salbroxol

Mucolytic drug Salbroxolum (Salbroxolum) is produced on the pharmacological market by the Ukrainian research and production center "Borshchagovsky Chemical and Pharmaceutical Plant". It was developed purposefully for use in protocols for the treatment of pulmonary patients. 

With colds and infectious diseases a person meets constantly, especially they are activated in the spring - autumn period. But if a person is struck not by a simple cold, and the symptomatology indicates a more severe lesion of the respiratory system affecting the bronchi, then an effective medication such as Salbroxol, possessing bronchodilating and mucolytic characteristics, will come to the rescue. Only it is necessary to remember one thing - to engage in self-medication: independently to make the diagnosis and to attribute preparations should not be. The appointment should be made by a specialist and only after a general examination of the patient's body and receiving the results of the tests. Only then can we expect a quick and effective result of stopping the disease.

 

Indications Salbroxol

Before appointing this or that drug, the treating doctor should thoroughly know the indications for Salbroxol, and they are not so numerous. This medicine was developed for purposeful action and is not systemic.

It is used in the therapy of such diseases:

1. Bronchitis (an infectious disease of the bronchial mucosa) is chronic, weighed down by obstruction factors (clogging of air passages).
2. Bronchial asthma is a chronic recurrent inflammatory disease of the respiratory system.
3. Emphysema of the lungs is a pathological change in the lung tissue, characterized by its increased airiness.

[1], [2], [3], [4],

Release form

This drug is presented by the manufacturer on the pharmacological market in the form of tablets - this is the only form of release of Salbroxol. But the tablets are arranged in ten units on one plate. Cardboard packaging can contain one, two, and four dozen pieces, represented, respectively, one, two and four plates in one carton.

One unit of the drug contains 15 mg of ambroxol hydrochloride - an active chemical compound and 4 mg of salbutamol sulfate. These are the main elements of the drug. They are accompanied by several other additional substances.

Pharmacodynamics

Each of the two main components of the drug in question, which pharmacologically complement and enhance each other's action, have their therapeutic characteristics, when combined, and the pharmacodynamics of Salbroxol is obtained. In order to understand what properties a drug possesses, we will separately consider the characteristics of each of its main components.

Ambroxol hydrochloride, when it enters the patient's body, shows secretory characteristics. Directly affecting the mucous and serous components, changing their ratio, it allows you to bring the composition of bronchial mucus back to normal. This component activates the functional features of the "life" of serous cells of the mucus glands, which are located in the structural walls of the bronchi. Ambroxol dilutes cumulative sputum in the bronchi, which makes it easier to remove them from the affected organ. This chemical compound makes it possible to reduce the volumes of mucopolysaccharide fibers, increasing their fragmentation. 

Due to the fact that ambroxol actively influences the eyelid outgrowths of the ciliated epithelium, it is possible to achieve effective mucociliary transportation of pathologic sputum. Ambroxol hydrochloride shows antioxidant characteristics and stimulates the synthesis of surfactant phospholipids.

The second active chemical of Salbroxol is salbutamol, which works fairly selectively, being an agonist of some receptors. That is, when interacting with beta2-adrenoreceptors, it changes their state, leading to a biological response. This characteristic makes it possible to prevent the onset of a spasmodic attack, and so it accompanies the growth of lumens in the bronchial organ. This effect is achieved due to a decrease in the excitation of the smooth muscle layer, which is the structural constituent of the bronchi.

This chemical compound allows to increase the stable state of mast cells and basophils. Salbutamol effectively blocks the growth of histamine structures, preventing the development of pathological factors that are reinforced by the action of histamine, for example, bronchospasm. In comparison with the other beta 2 - adrenomimetics, in the characteristics of salbutamol, a reduced effect on the myocardium is observed. This fact applies both to chronotropic and to inotropic aspects of influence.

Proceeding from the foregoing, Salbroxol is considered to be a complex medication of bronchodilating and mucolytic action.

The main properties of the complete preparation include the normalization of the secretory characteristics of bronchial mucus, the prevention of bronchospasm, as well as the improvement of the process of excretion from the bronchi, spittle accumulating in them. This is especially true for sick people, whose disease is burdened by the phenomena of obstruction.

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

Pharmacokinetics

The medicine enters the patient's body orally (through the mouth). The main components of salbutamol and ambroxol have a high absorbing level. The process of absorption is made by the mucosa of the gastrointestinal tract.

After taking the medicine, after half an hour, you can already observe the therapeutic effect, which, depending on the individual characteristics of the patient, lasts from six to twelve hours. Salbutamol, like ambroxol, is metabolized in the body of the patient. The ninth part of ambroxol is utilized by the patient's body through the kidneys together with urine in the form of metabolites, and the remaining one part is the excretion in unchanged form.

The bioavailability of ambroxol hydrochloride approaches 30 percent. This indicator is caused by the syndrome of "first penetration" through the liver.

Ambroxol shows high rates of connection with protein structures of plasma. This characteristic is close to 85%. In salbutamol, this indicator is much lower, and its bioavailability is from 40 to 50%.

Pharmacokinetics Salbroxol shows a high level of penetration of active agents through the hematoplacental barrier. The half-life (T1 / 2) of the drug in question is an average of six hours. 

Dosing and administration

Self-medication should not be prescribed. At the first signs of the disease it is necessary to make an appointment for a consultation with a doctor - an otolaryngologist or, in case of a serious condition of the patient, call a doctor at home. Only a specialist is able to adequately assess the situation and to write down an effective method of application and dose of the drug, which allows to obtain maximum therapeutic effectiveness in a specific pattern of the disease.

Salbroxol is developed by the manufacturer for oral administration. To get the maximum effectiveness of drug therapy, pharmacologists are advised to spread the time of drug administration and the intake of food. The interval between the procedures for drug administration should be strictly maintained and not reduced to less than six hours.

The duration of the therapeutic course, as well as the amount of the drug administered, is determined by the treating doctor specifically for each patient.
The recommended amount of Salbroxol for adult patients and adolescent children is usually one tablet taken three to four times during the day.

According to medical indicators, with a severe degree of disease, an adult patient may receive a single dosage twice and be brought to two tablets administered three to four times a day.

The maximum daily allowable amount of medication taken for an adult patient is eight tablets.

If during treatment the patient begins to notice the emergence of adverse side symptoms, dosage of the drug Salbroxol can be reduced by half and take half the tablet four times throughout the day.
 

[14]

Use Salbroxol during pregnancy

The pharmacodynamic characteristics of the mucolytic drug described above show a high permeability through the hematoplacental barrier, which indicates the high potential of active substances to enter the breast milk and the fetal diet in a woman who undergoes therapy with this medication during the period when she is carrying her child .

In the light of the above, it can be stated that the use of Salbroxol during pregnancy (in the first trimester) is strictly contraindicated. This is the most crucial period of pregnancy, when the formation of the baby's organs is going on and any external impact can lead to a "failure in the program" of the formation, which is fraught with the disability of the child, and even his death.

During the second and third trimester, Salbroxol is admissible for admission by a pregnant woman, but only in case of high therapeutic necessity, and only under the strict control of the treating doctor.

If a woman of childbearing age is ill and there was a need to undergo therapeutic treatment of Salbroxen, it is preliminary to exclude pregnancy. If the pregnancy is only planned, then for the period of treatment, the moment of conception should be postponed until the woman fully recovered, or find a replacement for the drug as one of the analogues.

If necessary, to quash the problem with this drug during lactation, it is necessary to raise the question of interrupting the feeding of the newborn with mother's milk. 

Contraindications

No matter how light and close to natural preparations the medicine in question is, it also has its limitations in the appointment. Contraindications to the use of Salbroxol are few, but they are still available:

1. This mucalt is not prescribed to patients who have a history of increased intolerance to ambroxol and / or salbutamol.
2. Diabetes.
3. Contraindication to the admission is galactosemia (a hereditary disease, which is based on a metabolic disorder in the way of galactose transformation into glucose).
4. Acute congestive heart failure, or heart disease of various genesis and degree of injury.
5.  Lactase insufficiency.
6. Arterial hypertension.
7. The syndrome of malabsorption of glucose-galactose - when glucose and galactose are not absorbed.
8. Myocarditis is an inflammatory lesion of the myocardium, caused by infectious, toxic or allergic effects.
9. Tachyarrhythmia - increased heart rate and heart rhythm disturbance.
10. Ulcerous and erosive lesions of the mucous membrane of the duodenum and stomach.
11. Thyrotoxicosis - the production of excessive amounts of thyroid hormones.
12. Hyperthyroidism is an increased amount of thyroid hormones.
13. Glaucoma - pathology of the optic nerve.
14. If the patient is already receiving one of the preparations of the group of beta-blockers.
15. The first trimester of pregnancy.
16. Lactation time.
17. The age of children who are not yet 12 years of age.

Particular care should be taken when prescribing and choosing the dosage of Salbroxol if the patient has a history of kidney and / or liver problems.

When therapy with this medication is not recommended to sit behind the wheel of vehicles and be more careful when working on unsafe moving mechanisms.

[9], [10], [11], [12]

Side effects Salbroxol

The drug in question is relatively easily tolerated by the patient's body, but there are still cases when side effects of Salbroxol, due to the action of the active components of the drug, are manifested.

Such symptomatology can be:

1. Tremor of upper and lower extremities.
2. Expansion of peripheral vessels. This symptom is mainly not manifested constantly, and when it occurs there is no need to cancel the medication taken.
3. Manifestations of allergy symptoms: itching, hives, hyperemia of the skin and others.
4. Pain symptomatology localized in the head region, as a reaction of the central nervous system to the action of the drug.
5. Dizziness.
6. Deterioration of the condition and decrease in the general tone of the body.
7. The patient has an increased work of the sweat glands.
8. Weakness and nausea.
9. Gastralgia - pain in the stomach, having the nature of contractions and appearing both in the pathology of the digestive organs, and with neuroses of a vegetative nature.
10. A sharp decrease in the numbers of blood pressure. This situation can lead to arterial collapse.
11. Paradoxical bronchospasm.
12. Increased blood glucose levels.
13. Convulsions and vomiting.
14. Cardiopalmus.
15. The rhythm of heart beats failed.
16. A feeling of fullness of the stomach.
17. Impairment of appetite.
18. Problems with defecation.
19. Quincke's edema is rare in rare cases.
20. Problem urination.
21. There are isolated cases when a person taking Salbroxol developed hypokalemia (a pathologically low level of potassium in the blood).

If one or more symptoms appear from the list listed above, you must inform your doctor. Treatment of these manifestations is purely symptomatic.
 

[13]

Overdose

When appointing a doctor of a medication, you must very carefully follow their recommendations for its reception, or strictly follow the instructions attached to the medicine. Otherwise, an overdose of the active ingredients of the drug may be obtained.

Symptomatic of excessive cumulation of the drug can be:

1. Arrhythmia.
2. High heart rate.
3. Tremor of upper and lower extremities.
4. Pain symptomatology appearing in the sternum.

If at this stage adequate measures are not taken, then a further increase in dosage can provoke:

1. Appearance of seizures.
2. Problems with sleep.
3. A sharp drop in blood pressure, up to the establishment of collapsing symptoms.
4. Edema of the Quincke.

If the symptoms described above appear, you should immediately rinse the stomach with a patient. It is advisable to immediately seek the help of a qualified specialist (call an ambulance). At strongly expressed signs of intoxication the medical worker, most likely, will enter to the victim the preparation belonging to the group of cardioselective beta 1-adrenoblockers.

[15], [16], [17], [18], [19]

Interactions with other drugs

Before appointing to a joint reception several drugs at the same time, it is necessary to know well their mutual influence on each other and their joint effect on the patient's body. Interactions Salbroxol with other drugs under certain conditions can cause irreparable harm to the human body.

It is strictly forbidden to take Salbroxol with drugs belonging to the group of drugs of beta-blockers. It is not recommended that the drug should be taken concurrently with drugs whose pharmacodynamics are aimed at arresting coughing attacks. For example, to such include glaucin, libexin, codeine and others.

When combined with the introduction of antimicrobial drugs, ambroxol provokes an increase in the concentration of antimicrobial substances in the bronchial secretion.

If the treatment protocol includes M-holinoblokatory, then their joint administration with Salbroxol significantly enhances the pharmacological properties of the latter. A similar result is obtained with tandem with theophylline. However, this combination can provoke a violation in the work of the heart - increasing the frequency of its contractions, as well as increasing the risk of getting supraventricular extrasystoles.

It is possible to observe the development of hypokalemia in tandem work of the components of Salbroxol and diuretics.

Glucocorticosteroids increase the responsiveness of beta-adrenoceptors to the active substances of the drug in question. An increase in the likelihood of progressive development of hypokalemia, with tandem combination of the drug in question with glucocorticosteroid drugs, was noted. The same result can be expected with the parallel introduction of Salbroxol and cardiac glycosides, which are xanthine derivatives.

When a combination of a mucal agent with monoamine oxidase inhibitors is established, the pharmacological properties of salbutamol are strengthened. This tandem also increases the likelihood of developing orthostatic hypotension. And in some cases it can provoke a collapsing state in the patient.
 

[20], [21]

Storage conditions

Before starting treatment therapy, it is necessary to read the recommendations that describe the storage conditions of Salbroxol in a home environment. Depending on how accurately these prescriptions are executed, the degree of efficacy of the drug will also depend throughout the pharmacological period of its use.

There are several such recommendations:

1. Keep the medicine in a cool place where the room temperature does not exceed + 25 ° С.
2. The room where Salbroxol is stored should be of low humidity.
3. It should be located in a place inaccessible to direct sunlight.
4. The drug should not be available to young children.

Shelf life

When buying any medication, you need to pay attention to its expiration date. Mandatory on the packaging of the medicinal product is reflected, both the date of production, and the recommended time of the end of admission. For Salbroxol, the effective work period is three years. If the end date of use on the package has already passed, then such a drug is not recommended for further use.