Salbutamol contraindications for use. Medicinal reference book geotar. Pharmacological action Salbutamol

Aerosol for inhalation salbutamol has a relaxing effect on the bronchi, this effect lasts for several seconds. 10 minutes after inhalation, the drug accumulates at the site of action, and 20 minutes after administration, the maximum pharmacological effect. The action can last up to 5 hours, depending on the general condition of the body.

The composition of the drug and the release form

One portion of the aerosol for inhalation contains:

• 124 g of the main substance - salts of salbutamol;
• additional components - ethanol, hydrofluoroalkane.

The formula of each manufacturer is individual. The most common components of the drug are listed above.

One tablet contains up to 4 mg of the active ingredient, the extended-release form includes up to 8 mg for an adult patient. It is important to take this into account when dosing.

Salbutamol is available in the following forms:

• metered-dose inhaler (available in pressurized aluminum cylinders, such an inhaler
• designed for 200 doses);
• powder divided into doses;
• coated tablets.

There are many varieties of medicines based on this active ingredient. Other manufacturers produce salbutamol in the following forms:

• tablet form retard;
• inhalation solution;
• syrup;
• concentrated liquid for self-preparation of the infusion form;
• capsules with Salbutamol.

Indications

There are several indications for treatment with the drug, their goal is to improve the patency of the respiratory apparatus for air flow and restore the function of external respiration. Without the use of an agent with this spectrum of action, death may occur from an insufficient supply of oxygen to the body. Salbutamol is used in such cases:

• attack bronchial asthma;
• the development of an allergic reaction to prevent pulmonary spasm;
• obstructive diseases of the respiratory apparatus, which have passed into the chronic stage;
• emphysema;
• bouts of suffocation.

Salbutamol helps to improve the patient's condition in a matter of seconds. It quickly stops an attack of bronchospasm of any etiology. Therefore, doctors recommend carrying it with you in order to quickly use it in an emergency.

Contraindications and unwanted effects

Salbutamol should not be used to treat the following conditions:

• high sensitivity to substances in the composition of the drug;
• disruptions in the work of the heart;
• congenital disorders of the structure of the heart;
• increased heartbeat;
• narrowing of the passage of the aorta;
• ischemic heart disease;
• excessive production of thyroid hormones;
• diabetes, proceeding according to the sugar type;
• epileptic seizures;
• glaucoma and similar diseases of the visual apparatus;
• narrowing of the direct section of the intestinal tract;
• insufficient work of the excretory organs;
• bearing a child.

The dosed drug is not prescribed together with non-selective adrenergic blocking agents, as well as for the treatment of children under 2 years of age.

Vigilance must be observed when the patient suffers from hyperthyroidism, adrenal tumors, with severe cardiac disorders, high blood pressure.

Salbutamol should not be administered intravenously in the following situations:

• death of the embryo;
• infectious processes in the birth canal;
• bleeding, which are provoked by placenta previa and its abruption;
• physiological abortion in the first two trimesters.

Salbutamol in aerosol form, when used for therapeutic purposes, does not cause negative effects.

For oral use of Salbutamol, the doses indicated by the manufacturer must be observed. In this case, the risk of adverse effects is minimal.

If you exceed the one-time or maximum permitted daily dose drug, then patients suffering from increased susceptibility to drugs with adrenergic activity begin to experience tremors of the limbs, internal anxiety and tension.

In case of an overdose, expansion of the walls of blood vessels in the periphery, migraine, often palpitations, nausea, muscle cramps may occur.

In rare cases, neurological edema develops, which manifests itself in the form of skin rashes, allergies, low blood pressure and bronchospasm.

Instructions for use

For patients over 12 years of age maximum dose Salbutamol per day for oral administration no more than 16 mg. It is divided into several steps. In case of urgent need, under the supervision of a specialist, the dosage is adjusted to 32 mg.

Children under 12 years of age are allowed to take 2 mg of Salbutamol 4 times a day. For patients under 6 years of age, the dose can only be increased to 2 mg, the frequency of administration for them is 3 times.

When using Salbutamol - Teva for inhalation, the dose is selected depending on the form of the drug. Adults are prescribed from 0.1 to 0.2 mg, children are half as much.

For each clinical situation, it is necessary to correctly select the frequency of application.

In order to prevent an asthma attack, Salbutamol - Teva is used in the permitted dosage. The maximum number of inhalations per day is 8 times.

The drug, released in powder form, should be used in the same way, but the dose must be doubled.

How to use an inhaler?

Before inhaling, you need to check the device for serviceability. This manipulation must be carried out in case of a long break between procedures.

The procedure for inhaling the drug:

• remove the cap from the inhaler and check for contamination;
• hold the can vertically, shake well before use;
• after inhalation, the head must be thrown back and the tube should be clamped with the mouth;
• while holding the tube with your lips, inhale, you need to press the switch for supplying the dose of medication;
• then they take out the tube and hold their breath for a while, after which they slowly exhale through the nasal opening.

If the patient needs to take more than one dose of salbutamol, then they take a break between inhalations and then proceed according to the described scheme. After the procedure is over, the balloon is closed with a valve.

With constant use, it is necessary to wash the parts of the inhaler.

If, when inhaled, steam comes out of the parts of the inhaler, then you need to return to the first point or check the device for leaks.

Duration and features of treatment

The duration of therapy is selected depending on the clinical case by the doctor. It is not used on its own. If adverse symptoms appear, you should contact a specialist to adjust therapy.

Use in pregnancy

Treatment with the drug should be excluded if present:

• the risk of abortion in the early stages;
• exfoliation of the placenta;
• bleeding;
• severe toxicosis at the last stage of bearing a child.

Salbutamol is prescribed only in life-threatening situations. Always take into account the appropriateness of the application, since there is high risk for the normal development of the fetus. Currently, there are few studies indicating the safety of using the drug in the first trimester of pregnancy.

Salbutamol is found in breast milk. During this period, you can not continue natural feeding of the child.

Shelf life

The drug can be used within two years from the date of manufacture, following the instructions. The storage location must be dark and dry. Do not open the cylinder, allow it to overheat or freeze.

Holiday conditions

The drug is released only with a prescription from a doctor.

Price and reviews

The cost of Salbutamol varies depending on the production. Usually the price does not exceed 250 rubles.

Consumers note the high effectiveness of salbutamol therapy for a nebulizer. Side effects develop quite rarely.

The only drawback of the nebulizer solution is the limited amount in pharmacies. In large cities, it can be difficult to find a remedy. Therefore, it is better to look for it in the suburbs or order in advance.

Conclusion

With all its side effects and limitations, this drug for inhalation is quite effective. For proper treatment and the success of therapy, it is necessary to adhere to the recommendations of the doctor.

In bronchial asthma, it is important to quickly stop attacks, especially in children. Therefore, doctors often prescribe Salbutamol as a bronchodilator. However, its use by children has a number of features.

Release form

"Salbutamol" is most often produced in the form of an aerosol for inhalation. Pharmacies sell a metal inhaler with a metering valve. This is the most popular form of "Salbutomol" because it is very convenient for permanent use outside the home or medical institution. The inhaler is designed for 200 doses.

Also in pharmacies are sold tablets "Salbuomol" 2 and 4 mg and prolonged action - 4 and 8 mg. Smaller dosages are used in children. In addition, capsules with powder for inhalation and injection solutions in 2 ml ampoules are produced.

One of the forms of release is a syrup with salbutamol. The syrup is sold in 100 ml bottles and is a viscous liquid with a lemon smell.

Compound

The main active ingredient of all drugs is salbutomol sulfate, which is a white crystalline powder that dissolves well in water. It belongs to beta-adrenergic stimulants - substances that can influence the course of many processes in the human body.

Salbatomol syrup also contains auxiliary components: stabilizers, citric acid to give taste and smell, sucrose, ethanol, and purified water.

In pharmacies there are combined syrups containing salbutamol. For example, Ascoril also contains mucolytics, bromhexine and guaifenesin. Three active components complement each other, contributing to a quick recovery from coughing.

You need to understand that such a syrup will not help with angina and others. inflammatory processes in the nasopharynx.

Operating principle

"Salbutomol" has an effect on beta2-adrenergic receptors located in the bronchi and blood vessels, relieves spasm and increases the amount of oxygen that a person can inhale.

During a spasm, this parameter is sharply reduced, the amount of oxygen entering the blood decreases, from which everyone suffers. internal organs and systems, including the brain and heart. After using the inhaler, the effect is achieved after 5 minutes. The action of "Salbutamol" lasts up to 3-5 hours. During this period, the recurrence of seizures is unlikely.

The negative consequences of taking "Salbutamol" include its ability to lower the content of potassium in the plasma. However, at recommended doses, it does not harm the cardiovascular system.

It is important that "Salbutamol" does not accumulate in the lungs and is excreted through gastrointestinal tract and with urine.

Indications

The main indications for the use of "Salbutamol" in children - various forms bronchial asthma. The drug helps to eliminate the attack in severe, moderate or mild, as well as cough forms of the disease.

Also, "Salbutomol" is able to prevent the occurrence of bronchospasm in a short period of time after contact with the allergen. For example, if a child inhaled some substance (toilet water, perfume, paint), then rapid use of the inhaler will prevent bronchospasm from developing.

"Salbutomol" is recommended for use before the upcoming physical activity: running, walking in the year, climbing stairs. It is important to ensure that, using Salbutamol as needed, the child does not exceed the maximum daily dosage.

"Salbutomol" is also prescribed on a regular basis as one of the components of comprehensive support for children with bronchial asthma and chronic obstructive pulmonary disease. "Salbutomol" is also effectively used in the treatment of acute and chronic bronchitis.

Salbutamol-based syrup helps children with severe coughs.

At what age are they prescribed?

According to the instructions for the use of "Salbutomol", syrup is not prescribed for children under 2 years old, and inhalers - up to 4 years. Young children 3-4 years old are not always able to use the inhaler correctly, so they are recommended to use special devices.

Contraindications

With individual hypersensitivity to the drug, treatment with Salbutomol is contraindicated for a child. Sometimes the drug is allowed to be used in children with heart disease, for example, severe heart failure, high blood pressure.

Side effects

With frequent use of "Salbutomol" in children, the head may hurt and feel dizzy, tremors and convulsions may appear. If a child uses an inhaler, then the signs of side effects are cough, dry mouth. In rare cases, various skin reactions occur - dermatitis, rashes, itching.

Blood and urine tests reveal such side effects"Salbutomol" as hyperglycemia - an increase in blood glucose levels, hypokalemia - a lack of potassium in the blood, as well as elevated level leukocytes. In rare cases, "Salbutomol" causes paradoxical bronchospasm.

Instructions for use

The dosage depends on the age of the patient and the purpose of the application. So, if it is necessary to stop an attack, children under 12 years old need one dose of inhalation, over 12 years old - two doses or 200 mcg of the drug. The number of doses may be increased during a severe attack. Before physical exertion or after contact with an allergen - two inhalations.

Children under 12 years of age can do no more than two inhalations at the same time, the exception is only in rare cases, if the course of the attack is severe. Children over 12 years of age can apply up to 3-4 inhalations at the same time. Adults are not allowed to do more than 12 inhalations per day, children under 12 years old - more than 8.

Overdose

It manifests itself with the same symptoms as with side effects, but more acutely. Palpitations, tremor of the hands and head, hyperreactivity should attract the attention of parents. During examination, there are also changes in blood tests - the content of potassium is less than normal, and glucose is more.

If an overdose occurs, contact medical care, with the attending physician, decide on the cancellation of treatment, and with the child, especially at the age of 3-4 years, instruct on the frequency of use of the inhaler.

Interaction with other drugs

Clinical trials show that salbutomol preparations can interfere with other medications, such as increasing the effects of stimulants.

Simultaneous reception with antidepressants can be dangerous, because it leads to a sharp decrease in pressure, up to loss of consciousness. The action of "Salbutomol" is enhanced by diuretics and Berodual.

Terms of sale and storage

"Salbutomol" is released in pharmacies only by prescription.

Salbutomold-based preparations should be stored at an air temperature not exceeding 30 C. They should not be frozen or left in the sun. The shelf life is 2 years. The inhaler must not be disassembled.

15 pcs. - cellular contour packings (2) - packs.

pharmachologic effect

Beta-agonist with a predominant effect on β 2 -adrenergic receptors (localized, in particular, in the bronchi, myometrium, blood vessels). Prevents and relieves bronchospasm; reduces resistance in respiratory tract increases lung capacity. Prevents the release of histamine, a slow reacting substance from mast cells and neutrophil chemotaxis factors. Compared with other drugs in this group, it has a less pronounced positive chrono- and inotropic effect on the myocardium. Calls an extension coronary arteries practically does not reduce blood pressure. It has a tocolytic effect, lowering the tone and contractile activity of the myometrium.

Pharmacokinetics

When using an aerosol, rapid absorption of salbutamol into the blood is observed; however, its blood concentrations, when used at recommended doses, are very low or below the limit of detection.

After oral administration, salbutamol is well absorbed from the gastrointestinal tract. Plasma protein binding is 10%. Metabolized during the "first pass" through the liver and possibly in the intestinal wall; the main metabolite is an inactive sulfate conjugate. Salbutamol is not metabolized in the lungs, thus its final metabolism and excretion after inhalation depends on the route of administration, which determines the ratio between inhaled and inadvertently ingested salbutamol.

T1 / 2 from blood plasma is 2-7 hours. Salbutamol is rapidly excreted in the urine in the form of metabolites and unchanged substance; in small amounts excreted with feces.

Indications

Prevention and relief of bronchospasm in all forms. Reversible airway obstruction in chronic bronchitis and pulmonary emphysema, broncho-obstructive syndrome in children.

threatening premature birth with contractile activity of the uterus; childbirth before 37-38 weeks; isthmic-cervical insufficiency, a decrease in fetal heart rate depending on uterine contractions during periods of cervical dilatation and expulsion. For prophylactic purposes during operations on the pregnant uterus (imposition of a circular suture in case of insufficiency of the internal os of the uterus).

Contraindications

The threat of miscarriage in the I and II trimesters of pregnancy, premature detachment of the placenta, bleeding or toxicosis in the III trimester of pregnancy; childhood up to 2 years; hypersensitivity to salbutamol.

Dosage

Inside as a bronchodilator for adults and children over 12 years old - 2-4 mg 3-4 times / day, if necessary, the dose can be increased to 8 mg 4 times / day. Children aged 6-12 years - 2 mg 3-4 times / day; children 2-6 years old - 1-2 mg 3 times / day.

When administered by inhalation, the dose depends on the dosage form, the frequency of use depends on the indications and the clinical situation.

As a tocolytic agent, it is administered intravenously in a dose of 1-2 mg.

Side effects

From the side of cardio-vascular system: transient expansion of peripheral vessels, moderate tachycardia.

From the side of the central nervous system:, dizziness, nausea, vomiting.

From the side of metabolism: hypokalemia.

Allergic reactions: in isolated cases - angioedema, allergic reactions as skin rash, urticaria, arterial hypotension, collapse.

Others: tremor of the hands, internal trembling, tension; rarely - paradoxical bronchospasm, muscle cramps.

drug interaction

With the simultaneous use of salbutamol with non-cardioselective, mutual suppression of therapeutic effects is possible; with theophylline - the risk of developing tachycardia and arrhythmia, in particular supraventricular extrasystole, increases.

With the simultaneous use of salbutamol and xanthine derivatives, corticosteroids or diuretics, the risk of developing hypokalemia increases.

special instructions

Use with caution in tachyarrhythmias and other rhythm disturbances, arterial hypertension, myocarditis, heart defects, aortic stenosis, diabetes mellitus, thyrotoxicosis, glaucoma, acute heart failure (subject to close medical supervision).

An increase in the dose or frequency of salbutamol intake should be carried out under the supervision of a physician. Reducing the interval is possible only in exceptional cases and must be strictly justified.

When using salbutamol, there is a risk of developing hypokalemia, therefore, during treatment in patients with severe bronchial asthma, the level of potassium in the blood should be monitored. The risk of hypokalemia increases with hypoxia.

Pregnancy and lactation

Salbutamol is contraindicated in case of a threatened miscarriage in the I and II trimesters of pregnancy, premature detachment of the placenta, bleeding or toxicosis in the III trimester of pregnancy.

If it is necessary to use salbutamol during pregnancy, the expected benefit of treatment for the mother and the potential risk to the fetus should be correlated. Currently, there is insufficient data on the safety of salbutamol in early pregnancy. Salbutamol is excreted in breast milk, therefore, if necessary, use during lactation should also evaluate the expected benefits of treatment for the mother and the possible risk to the child.

R.03.A.C Selective beta-2-agonists

R.03.A.C.02 Salbutamol

The drug Salbutamol is produced by pharmacological companies in the form of an aerosol. The drug belongs to the group of beta2-adrenergic receptor agonists. The composition is used to restore airway patency in obstructive pulmonary pathologies. Salbutamol has its own indications, and contraindications for use with which you should familiarize yourself before starting use.

Dosage form

Salbutamol is produced in the form of an opaque aerosol. Produced in a metal container equipped with a valve and sprayer.

Description and composition

The active substance of the metered-dose aerosol for inhalation is salbutamol. Propylene is present as an auxiliary component in the composition of the product.

Pharmacological group

Beta-agonist with a pronounced effect on β2-adrenergic receptors located, in particular, in the bronchi, myometrium and blood vessels. The active substance of the drug has an effect on the receptors, against the background of such an action, smooth muscle relaxation occurs, and the bronchus lumen expands. Based on such therapeutic efficacy, a better bronchodilator effect is achieved associated with the restoration of normal patency of the bronchial tree.

After the active substance of the spray enters the respiratory tract, about 20% of the active ingredient reaches the small bronchi. The main part of the components settles on the mucous membranes of the respiratory tract and is absorbed into the systemic circulation. The active component of the drug is excreted by the liver, while forming inactive decay products. The results of the activity of the active substance are excreted from the human body with urine.

Indications for use

The list of indications for the use of the drug is presented in the following form:

• expansion of the bronchi to improve respiratory activity;
• decrease in the intensity of the manifestation of shortness of breath in obstructive syndrome;
• elimination of an attack of shortness of breath in bronchial asthma;
• elimination of allergic bronchospasm;
• obstructive pathologies of lung tissues.

The agent can be used as one of the components that make up the complex therapy for bronchial asthma. The drug component can be used to reduce the likelihood of dyspnea attacks associated with pathological narrowing of the bronchial tree.

for adults

The drug is often prescribed to adult patients and the elderly in the presence of indications for use. Before proceeding with the use of the composition, the patient should carefully study the features of its use and storage. It is also worth eliminating the risk of the presence of contraindications.

for kids

For stopping attacks of shortness of breath can be used in pediatric practice. The tool can be used to treat pathologies of the respiratory system in children over the age of 3 years. The patient's condition should be constantly monitored, in case of manifestation of pathological changes, the use of the drug is stopped.

Salbutamol is not recommended for use during pregnancy. The mechanism of action of the active component on the process has not been fully studied. The tool is used during pregnancy and breastfeeding in the presence of vital indications.

Contraindications

The list of contraindications to the use of the medicinal composition is presented in the following form:

• patient intolerance to the main or auxiliary component of the medicinal composition;
• children's age up to 3 years;
• the threat of abortion in the 1st and 2nd trimester;
• late toxicosis;
• early detachment of the placenta.

Use of the drug in the presence of contraindications is prohibited. Such actions can cause a significant deterioration in the patient's well-being.

Applications and doses

Recommended dosages largely depend on the age of the patient and the clinical situation. Instructions for use regulate general indications, but more accurate doses can be determined by the doctor after the examination and the results of the examination.

for adults

Patients are prescribed 2-4 mg of the drug 3-4 times a day. If necessary, the dose can be adjusted and increased by a specialist.

for kids

Children aged 2 to 6 years are prescribed 1-2 mg of the drug 3 times a day.

Children aged 6 to 12 years are prescribed 2 mg of the drug 3-4 times a day.

for pregnant women and during lactation

It is used in the presence of acute, vital indications in dosages determined by a specialist.

Side effects

The list of side effects that can occur during the use of the drug include:

• sustained expansion of peripheral vessels;
• moderate tachycardia;
• dizziness and headaches;
• hypokalemia;
• nausea, ending in vomiting;
• arterial hypotension;
• collapse;
• internal trembling;
• generalized tics;
• bronchospasm;
• muscle cramps.

Interaction with other drugs

Non-cardioselective beta-blockers can suppress the active effect of the active substance. When used with theophylline, the risk of developing tachycardia and arrhythmias increases. When taken with glucocorticosteroids and diuretics, the risk of developing hypokalemia increases.

special instructions

The list of special instructions that you should read before using the product is as follows:

1. The aerosol must be used correctly, otherwise the active substance may not enter the respiratory tract.
2. If the recommended initial doses are ineffective, the treatment plan should be reconsidered. With the ineffectiveness of the measures taken, the dose is increased.
3. Salbutamol cannot be used as the main treatment for bronchial asthma. The composition of the treatment regimen should include glucocorticosteroids.
4. The active substance can provoke the activation of the work of the heart muscle, the development of arrhythmia or tachycardia is not excluded.
5. Some manifestations of disorders from the nervous system are possible, therefore, during the period of application of the composition, patients should refuse to drive a car.

The drug is dispensed to the public through a network of pharmacies without a prescription, however, you can resort to using the drug only after consulting a specialist.

Overdose

With a significant excess of dosages, the following disorders may develop:

• heart rhythm failures;
• tachycardia;
• arrhythmia;
• patient hyperactivity;
• hypokalemia.

At the first suspicion of an overdose, you should seek medical help. The specialist will be able to determine the optimal symptomatic therapy.

Storage conditions

The permissible shelf life of Salbutamol aerosol is 2 years. The product should be stored in its original packaging out of the reach of children. The drug must not be frozen or left under the influence of sunlight.

Analogues

On sale there are complete analogues of the drug Salbutamol:

1. . This is an imported drug manufactured by GlaxoSmithKline, UK. On sale it can be found in the form of a metered aerosol, which, unlike Salbutamol, can be used in children under 3 years of age at a dosage of 100 microns per 1 inhalation, but more often 4 times a day. It also has a longer shelf life (36 months), it can be stored at temperatures up to 30 degrees.
2. Nebulas. This is a solution for inhalation through the mouth, which is produced by GlaxoSmithKline. It is used to stop attacks of bronchial asthma, treat chronic lung diseases with obstruction in adults and children over 1.5 years old. For inhalation, you need a nebulizer.

Also on sale are partial analogues of the drug, which, in addition to salbutamol, contain other active substances:

1. Ipramol Steri-Neb. The drug is produced in the UK, which is available in the form of a solution for inhalation using a nebulizer. As active ingredients, it additionally contains ipratropium bromide, so the drug has more contraindications and often causes unwanted reactions compared to salbutamol. Ipramol Steri-Neb should not be prescribed to children under 12 years of age and in the first 13 weeks of pregnancy.
2. SamaComb. The drug is produced in the form of an aerosol, it is a combined medication containing a local glucocorticosteroid and a selective β2-agonist. The drug has the same indications for use as Salbumatol, but it is contraindicated in minors and women who are breastfeeding.

It is not recommended to replace Salbutamol with a structural analogue without prior consultation with a specialist, such a replacement may cause a deterioration in the patient's well-being.

Price

The cost of Salbutamol is an average of 157 rubles. Prices range from 73 to 312 rubles.