Salbutamol

The medicament considered in this article is attributed to preparations of synthetic origin, designed to provide emergency medical care. Salbutamol (Salbutamol) - this drug has anti-inflammatory characteristics and belongs to the group of clinical and pharmacological agents that have bronchodilator and mucolytic properties. Salbutamol is a drug assigned to the group of beta 2 - adrenomimetics.

Any disease affects to a greater or lesser extent the quality of our life. Therefore, in order not to exacerbate the clinical picture, at the first attacks of bronchial asthma with manifestations of bronchospasm, you should immediately seek the advice of a specialist. Not knowing the pharmacodynamics of the drug and its characteristics of interaction with other drugs, one should not engage in self-medication. This attitude towards therapy can turn into serious complications, worsening the patient's condition. Only a qualified specialist on the basis of the clinical picture and the state of health and anamnesis of the patient can paint a really effective and minimally safe protocol of medical therapy. Salbutamol is a high-quality medicine with bronchodilating and mucolytic characteristics, which effectively stops or prevents spasms of bronchial tissue structure. He will improve the patient's condition, returning him to a normal life, but you should not deviate from the recommendations that the doctor gave.

[1], [2], [3]

Indications Salbutamol

Before proceeding to the development of any drug, it is necessary to imagine what indications should be used for the use of Salbutamol, and, accordingly, such pharmacological characteristics it should possess.

Therefore, having the necessary chemical and biological characteristics, Salbutamol can be used in the treatment of such pathological diseases:

1. Preventive maintenance of spasms of a bronchial asthma at any form of its course.
2. Direct relief of suffocating seizures.
3. Improvement of the patient's condition in the presence of obstructive processes in the patient's body, which is characterized by narrowing or full overlapping of the passage section of the lumens in the bronchi. Therapy is effective in reversing the process of obstruction.
4. Prevention of possible complications of bronchitis.
5. Broncho-obstructive syndrome in small patients.
6. Emphysema of the lungs - increased airiness of the lung tissue.
7. Premature obstetrics, which is associated with a high tone of the contractile activity of the uterus. This pathological failure during pregnancy is a threat to the viability of the fetus. This pathology is especially dangerous if the woman has a gestation less than 37 weeks.
8. Reduced number of heartbeats in the newborn in the process of obstetric care at different stages of the birth process.
9. Low tone of the functional activity of the cervix. Isthmiko-cervical insufficiency.
10. Preventive measures that are carried out immediately before the operative intervention affecting the womb of a woman who at this time is carrying her baby.

[4], [5], [6]

Release form

Advantageously, Salbutamol, an active active chemical-pharmacological compound, which is salbutamol, like other drugs developed on the basis of this chemical, is represented by aerosols. This form of release is one of the most "in demand", as it is very convenient and easy to use. The aerosol form has, in addition to the main active chemical compound, fluorotrichloromethane and difluodichloromethane, as well as ethanol and oleic acid.

Salbutamol is produced by the manufacturer in the form of a bottle of aluminum, provided with a protective cap, which simultaneously functions as a dispensing device. To spray the mouth and throat with medicinal medicine, you just need to press on the dispenser and it will "give out" the amount of the drug, which is 0.1 mg. That is, 0.1 mg is a single depression - this is a single dose.

Another form of medicine in which this medication is produced is a tablet, which, on drugstore shelves, can be found in two dosages of the active substance: 2 mg or 4 mg per unit of medication. The form of the package at a dosage of 2 mg is a blister of 15 pieces, which are packaged in a cardboard box with two blisters. The form of packaging at a dosage of 4 mg is a bottle of glass.

Much rarer, but still Salbutamol is used and as a solution for injection, which is used for intravenous drip infestations.
 

[7], [8], [9], [10], [11],

Pharmacodynamics

With the correct choice of dosage, Salbutamol effectively activates the work of beta 2-adrenergic receptors located on the surface layer of the bronchial lining. There are such receptors in the muscular tissues of the uterus, as well as they serve the blood vessels.
Pharmacodynamics Salbutamol helps block the release of active chemical compounds from mast cells, which occurs for a long period of time.

The action of the medication makes it possible to make a large vital volume of the lungs. This parameter is measured if, with a deep sigh, measure the volume of exhaled without much effort.

Salbutamol helps prevent spasm of the bronchi, and in the event that such an attack occurs, actively, in a matter of minutes, arrest it. The active substance reduces the resistance of the passages in the airways, blocking the bronchial reactivity.

Salbutamol somewhat dilutes the sputum cumulating in the bronchi, facilitating their withdrawal. It allows to stimulate the functioning of the cellular structures of the ciliated epithelium, which prevents the provocation of the bronchospasm spasm caused by the patient's allergic reaction to an external stimulus. At certain factors, the medication is able to influence the synthesis of insulin in the blood (increase in glucose level) and the fragmentation of glycogen (namely, lipids), which is very important for diabetics. There are situations where the clinical picture on the background of therapy, in which the protocol includes Salbutamol, shows a decrease in the amount of potassium in the patient's blood plasma.

Beta-adrenomimetics, to which the present drug belongs, has a direct effect on β ₂ -adrenoceptors.

Compared with other drugs in this group, Salbutamol does not significantly affect the components of the cardiovascular system. This applies both to inotropic and chronotropic effects. When treating this drug, there is no abnormal change in blood pressure values. Under the influence of this medication, in a few cases a slight increase in the diameter of the coronary vessels of the heart is observed.

This drug works effectively to reduce the tone and intensity of contraction of the myometrium, influencing this organ of the sexual system of a woman tocolytically.

[12], [13], [14],

Pharmacokinetics

High efficacy of pharmacokinetics Salbutamol shows that the therapeutic result, in the case of aerosol administration, begins to be observed already during the first minutes of the drug. The maximum effectiveness is achieved after half an hour - an hour from the time of the introduction of the medicine. This indicator directly depends on the individual characteristics of the organism of each particular patient. The effect of the drug, used in the form of an aerosol, is observed for another three hours.

If the form of taking the pill is, this method is more prolonged, and the effectiveness of the clinical picture of the disease can last from six to eight hours. But when taking pills, there are drawbacks, in comparison with aerosol, - the medicinal effect comes only after half an hour after their adoption.

 In the case of an aerosol administration, the substance administered is rapidly absorbed into the blood, but in this case, the patient's salbutamol concentrations determined in the study are not observed in the blood or are detected in very small doses.

The active active substance of the medicament in question shows a low percentage (only 10%) of binding to blood proteins. Processes of metabolism of Salbutamol occur in the liver during its primary passage. The main metabolite of the basic chemical compound of the drug is the inactive sulfate conjugate.

The main way to remove the drug is to dispose of metabolites in a larger and unchanged substance to a lesser extent through the kidneys, together with the urine. A small number of them goes to their patient's body along with bile or calves.

The half-life (T _1/2 ) of this drug is between two and seven hours. This indicator essentially depends on those characteristics of a state of health which the organism of the patient shows at the moment of therapy.

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

Dosing and administration

If the patient's anamnesis shows the need to connect to Salbutamol medicinal therapy, the treating doctor, depending on the pattern of therapy and the patient's condition, chooses the most effective way of using and dosing the medicine.

When prescribing a medicine in the form of an aerosol, one or two doses of the medicine are allowed, which corresponds to one - two clicks on the cap - the dispenser of the aerosol can, respectively. To remove bronchospasm - this is quite enough. If after 10 minutes there is no improvement in the patient's condition, then another dose of the drug is allowed in the same dosage. Then it is necessary to maintain an interval in inhalations not less than four to six hours (it is better, if possible, to sustain six). The number of inhalations during the day should not exceed six procedures.

When the drug is given in the form of tablets, as a bronchodilator, adults and adolescents who are already 12 years of age, the recommended dose is 2-4 mg (one tablet, taking into account the concentration of the active substance) administered orally three to four times during days.

With therapeutic need, the amount of the drug can be increased to 8 mg (4 tablets with a 2 mg dose or 2 tablets with a 4 mg dosage) administered four times throughout the day. Hence, the maximum daily amount of a drug that a patient can take for one day is 32 mg.

To small patients, the age of which falls in the interval from six to 12 years, it is recommended to take 2 mg (one tablet) three to four doses throughout the day, to children from two to six - 1 to 2 mg three times during the day.

As a tocolytic agent, Salbutamol is administered intravenously at a dose of 1 to 2 mg.

[23], [24], [25], [26], [27], [28]

Use Salbutamol during pregnancy

If a woman has a period of pregnancy burdened with bronchial asthma, the use of Salbutamol during pregnancy is entirely acceptable, but the medication should be taken with careful adherence to prescribed therapeutic dosages. In this case, the pregnant woman should be under the constant supervision of a doctor - gynecologist, who leads her pregnancy.

Previously, women who had a history of such a diagnosis, to become pregnant and bear a baby was strictly forbidden. Modern women with such problems got the opportunity to become mothers thanks to such a drug as Salbutamol. It effectively prevents the onset or arrest of an already started attack of bronchospasm.

Apply the medication in question and if the pregnant woman has a premature birth process. This is particularly true when the pregnancy is less than 37 weeks. Salbutamol also helps in the case when the doctor diagnoses a future mother with placental insufficiency.

But it should be clearly remembered that the medicament can be prescribed only by the attending physician and only in a situation where the therapeutic effect when taking it for a pregnant woman is significantly more significant than the harm that can threaten her unborn baby.

To date, there is no reliable data on the effect of salbutamol on fetal development in the early stages of pregnancy. Therefore, the obstetrician-gynecologist prefers to avoid prescribing this medication in the first trimester of pregnancy and with special caution goes to this during the second trimester. 

The active substance penetrates into the breast milk of a woman, so if the therapy is necessary for a woman at the time when she feeds her newborn baby with mother's milk, it is necessary to refuse breastfeeding and transfer the baby to artificial nutrition, because the modern food market offers a wide range of baby food .    

Contraindications

The drug in question is a synthetic chemical compound possessing a chemically active substance, which produces an effect on the patient's body. But completely to exclude its influence on other organs and systems it is not possible, especially it concerns a tablet form of drug administration in a sick organism. Therefore, there are
Contraindications to the use of Salbutamol, which are due to:

1. The age of the patient. For example, a medicine, in the form of an aerosol, is not allowed to enter babies whose age has not reached two years, whereas up to four years it is forbidden to use its tablet form and powder for inhalations.
2. Premature detachment of the placenta in a pregnant woman.
3. Individual intolerance to the component components of the drug.
4. Threat of miscarriage, which falls on the first or second trimester of bearing a baby.
5.  Uterine bleeding in the third trimester of pregnancy.
6. Late toxicosis.

In other cases during pregnancy, the intake of this medication is under the close scrutiny of the attending physician.

Salbutamol should be used with particular caution in the treatment of people who suffer from tachyarrhythmia, as well as those with a history of serious cardiac problems (eg, aortic stenosis, acute heart failure, heart disease, myocarditis). Under the control of the doctor, the medication taken should also be taken if the patient is ill with diabetes mellitus, hypertension, optic nerve damage (glaucoma), thyrotoxicosis (an excess of thyroid hormones in the body).

If there is a therapeutic need to reduce the interval between medications (this step should be exceptional and clinically justified) or increase its dosage, these changes should be adjusted by a specialist. Admission of medication with a modified protocol of treatment should be carried out under the constant supervision of a doctor.

Against the background of Salbutamol therapy, there were cases when development of hypokalemia was observed. Therefore, during the treatment of bronchial asthma, you should regularly monitor the level of calcium in the patient's blood. The probability of this pathological deviation is higher, the more pronounced the hypoxia.

[20], [21]

Side effects Salbutamol

Taking medication sometimes causes an unpleasant side symptomatology, which in some cases requires immediate cessation of the medication and replacing it with another analog. Either dosage adjustment or symptomatic treatment is performed.

Side effects Salbutamol versatile.

Mostly can occur:

• Tremor of the upper (predominantly) and lower extremities. This symptom is enough for a part of the beta-adrenoreceptor group. Much depends on the dosage of the medicine taken.
• The patient can feel the inner trembling.
• Enhanced palpitations.
• Problems with sleep.

Somewhat less often observed:

• Dizziness.
• Irritability.
• Pain symptomatology affecting the head area.
• Nausea, and with a special intensity and the urge to vomit.
• Increase in the diameter of the passageway of the peripheral vessels of the brain.
• Drowsiness.
• Hyperemia of the skin.

Rarely, but can manifest themselves:

• Angioedema.
• Hallucinations.
• A sharp fall in blood pressure, down to an unconscious state and collapse.
• Attack of bronchial spasm.
• Hypersensitivity and allergic reaction of the body: urticaria, itching, skin rash and others.
• Unstable psychological state.
• Ventricular fibrillation.
• Cardiovascular failure.
• Hypokalemia - a decrease in potassium in the patient's blood.
• Increased hyperactivity in small patients.
• Irritation of the mucous membrane of the mouth and pharynx.
• Supraventricular extrasystole.
• Muscle cramps.

If the patient or his relatives begin to observe the appearance of one or more symptoms from this list, you should immediately notify your doctor about it.

[22]

Overdose

If the recommended doses of the drug taken have been violated, or because of the individual characteristics of the patient's body and its history, the administration of Salbutamol may lead to an overdose of the drug exhibiting its symptoms.

When taking medication in the form of tablets, you can expect such pathological manifestations:

1. Appearance of rapid heart rate.
2. Failure in the work of the heart rate.
3. Convulsions.
4. Pathological changes in blood pressure indicators: both in the direction of a sharp increase, and in the direction of a rapid decrease in these values.
5. Dizziness.
6. Insomnia.
7. Tremor of the upper extremities.
8. Pain symptomatology in the heart.
9. The risk of hypokalemia is high.

Excess of active substance in the patient's body after taking the drug in the form of an aerosol can cause excessive stimulation of b-adrenergic receptors, as well as symptomatology similar to the above.

Therapeutic therapy, when there are signs of an overdose, consists of several points.

1. Abolition of the medication that caused the emergence of secondary symptoms.
2. Carrying out measures for the provision of first aid: washing the stomach, introducing adsorption materials (for example, activated carbon).
3. Purpose of appropriate symptomatic therapy. The victim is given an antidote, a medicine that belongs to the group of drugs of cardioselective b-blockers. But all these medicines must be attributed very carefully, especially if there is a pathology such as bronchospasm in the patient's medical history.
4. If it is necessary to continue treatment of the underlying disease, another drug with bronchodilator and mucolytic properties is attributed, but has several other characteristics. The dosage of the drug is also adjusted.
5. Due to the fact that against the background of taking Salbutamol may develop a severe form of hypokalemia, regular monitoring of the quantitative component of potassium in the blood serum is necessary.
    

[29], [30], [31],

Interactions with other drugs

Some people do not even think when against the background of one treatment, they start taking drugs of a different pharmacological orientation. For example, we treat bronchitis, grabbed the stomach, a person, without hesitation, begins to independently drink drugs from the gastric pathology. And then start to wonder that there is another pathological symptomatology or therapeutic effectiveness is weak.

Therefore, before prescribing a specific drug, it is necessary to know the interaction of Salbutamol with other drugs in order to prevent the development of additional pathological symptoms.

Non-cardioselective beta-blockers whose pharmacodynamics are aimed at stopping angina pectoris, when administered concomitantly with the drug in question, act mutually, that is, when combined, the expected therapeutic efficacy does not occur in the treatment of either one or the other disease.

Simultaneous reception of Salbutamol and theophylline leads to an increase in the likelihood of developing such negative manifestations as a failure in the heart rate and an increase in the heart rate.

If in parallel, in one treatment protocol, there are glucocorticosteroids and Salbutamol, you can expect the development of hypokalemia. A similar result is obtained when the drug is administered jointly with diuretics, that is, their combined use can lead to a sharp drop in the level of potassium in the patient's blood.

Given that the medicine prescribed for the relief of bronchospasm spasmodically affects the sympathetic nervous system, patients whose history is burdened by epileptic attacks, ocular nerve damage (glaucoma), pathological changes affecting the organs of the cardiovascular system, as well as in hyperthyroidism ( endocrinological syndrome caused by thyroid hyperfunction), against the background of the main treatment, with special care it is necessary to prescribe the method of taking and dosage of Salbutamol.

It should also be noted that in the event that the reception of the drug in question does not bring the expected result or its effect extends to less than three hours, in such a situation it is necessary to inform its treating doctor.

[32], [33], [34]

Storage conditions

When buying this medication, it is necessary to pay attention to the storage conditions of Salbutamol, in a home environment. After all, the quality of the remaining pharmacological properties depends on how well the recommendations given in the instruction accompanying the drug are met, which must meet the properties attached to it throughout the therapeutic period.

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 Salbutamol should be stored should be dry.
3. The storage location should not be exposed to direct sunlight.
4. Throughout the operational period, it is necessary to protect the spray can (with the aerosol form of drug administration) from falling and deforming the package.
5. The drug should not be available to young children.

[35], [36], [37], [38], [39]

Shelf life

After purchasing a drug, you should definitely familiarize yourself with the timing of the drug and especially pay attention to the end date of effective operation, which must necessarily be reflected on the packaging of any product. If this date is overdue, the medicine in question should not be used in the future. The shelf life of the salbutamol in question, depending on the manufacturer who produced the drug on the pharmaceutical market, can range from one and a half to four years. 

[40], [41]