Bronchodilators play a key role in the complex therapy of diseases of the respiratory system due to the development of obstruction. Currently, a number of drugs are used in medical practice to relieve bronchospasm. Some of the most effective are Salbutamol and Berodual .
Indications for use
The appointment of Salbutamol and Berodual is indicated for bronchial asthma, chronic obstructive pulmonary disease, and chronic bronchitis. Drugs belong to symptomatic therapy, which is aimed at stopping exacerbations.
Salbutamol is used during attacks of bronchospasm, accompanied by suffocation, coughing, shortness of breath. There are also tablet forms that are long-lasting and are used when symptoms develop at night. Inhalation administration of the drug is possible to prevent an exacerbation of the disease upon contact with an allergen or physical activity. The drug is used in the differential diagnosis of asthma and COPD as a provocative agent in the study of respiratory function.
In addition, Salbutamol is used in pathological pregnancies, when there is a risk of premature birth from 16 to 38 weeks.
Berodual is included in the complex therapy of first-stage bronchial asthma, that is, with an intermittent form. This stage of the disease is characterized by rare episodes of exacerbation, a moderate decrease in the forced expiratory volume per second – at least 80% of the norm, as well as rare nocturnal attacks or their absence. Randomized placebo-controlled clinical trials have shown high efficacy of the drug in relation to the severity of the bronchodilatory effect, since it contains two active substances of different pharmacological groups. The drug acts on two points at once – specific receptors of the bronchi and smooth muscle cells.
Long-term therapy with bronchodilators is indicated at the third and fourth stages in severe asthma, especially in the presence of frequent nocturnal attacks.
Contraindications
Salbutamol is contraindicated:
- in case of an allergic reaction or individual intolerance to the components of the drug;
- in the event of a threatened abortion;
- children under two years old.
The medicine is prescribed with caution if the patient has:
- myocarditis of various origins;
- congenital and acquired heart defects;
- suffered myocardial infarction, decompensated heart failure;
- uncontrolled arterial hypertension, both essential and symptomatic;
- endocrine pathologies – pheochromocytomas, hypo – and hyperthyroidism;
- epilepsy;
- renal failure with a pronounced decrease in the filtration capacity of the glomerular apparatus.
Do not take concomitantly with indiscriminate beta blockers.
Contraindications to Berodual are:
- allergy or intolerance to the active components of the drug;
- hypertrophic cardiomyopathy with obstruction;
- violation of the heart rhythm – tachyarrhythmias;
- first trimester of pregnancy.
The drug should be used with caution in people with:
- uncontrolled diabetes mellitus;
- high blood pressure;
- angle-closure glaucoma;
- cystic fibrosis;
- a history of myocardial infarction and stroke.
Salbutamol and Berodual are contraindicated in pregnant women in the first trimester. The active ingredients have a negative effect on the child. However, the balance of benefits and risks should be assessed, therefore, in some cases, these drugs may be prescribed to pregnant women.
Difference in composition
Despite the same purpose of the two drugs and a similar therapeutic effect, there is a difference in their composition and pharmacodynamics .
Salbutamol is a one-component drug, the active substance of which is a selective beta-2-adrenergic agonist. The substance activates specific receptors, resulting in a therapeutic effect.
Berodual, in contrast to Salbutamol, is a combined agent containing a selective beta-2-adrenomimetic fenoterol and an m- anticholinergic blocker ipratropium bromide.
The mechanism of action of drugs
Salbutamol selectively interacts with beta-2-adrenergic receptors of the autonomic nervous system, which are located mainly on the membranes of bronchial smooth muscle cells. Once in the body, the active component binds to receptors and causes relaxation of smooth muscles by reducing the concentration of calcium ions in them, as a result of which an acute attack of bronchospasm is stopped. The drug also inhibits the release of pro-inflammatory mediators, in particular histamine, from mast cells. To some extent, Salbutamol improves the clearance of the bronchi, that is, it enhances the movement of the ciliary epithelium, which means it quickly removes mucus and phlegm.
Berodual affects several points thanks to its combined composition. Fenoterol belongs to beta-2-adrenergic agonists, therefore it has the same effect as Salbutamol . Ipratropium is an m- anticholinergic antagonist . Its mechanism of action is based on inhibition of muscarinic receptors and a decrease in the influence of the vagus nerve on myocytes, which is accompanied by relaxation of smooth muscle cells of the tracheobronchial tree. It has the best effect on the bronchi of large and medium caliber. The compound reduces mucus production by the goblet cells of the lung tissue.
How to take it right
The dosage, frequency of administration and duration of the course are determined by the attending physician based on the course, form of the disease and other indicators.
Most often, drugs are prescribed for inhalation. To achieve the maximum effect from inhaling the medicine, you should adhere to some rules:
- Before using the product, you must open the cap and carefully examine the mouthpiece – it must be intact and clean.
- Shake the bottle.
- The inhaler is placed in an upright position with the bottom up between the thumb and forefinger.
- The mouthpiece is tightly wrapped around the lips, exhaling slowly.
- Simultaneously with pressing the mouthpiece, take a deep breath and hold your breath for a few seconds. If steam escapes at the corners of the mouth at the time of the procedure , inhalation is considered ineffective. In this case, the medication is started again.
- At the end of the procedure, the mouthpiece is taken out of the mouth and exhaled slowly. If a double dose is prescribed, then the manipulation is repeated after 20-30 seconds.
- After the completion of inhalation, the vial with the medication is tightly closed with a cap.
There are tablet forms of Salbutamol designed to prevent nighttime exacerbations.
Which drug is more effective
Salbutamol and Berodual have a good therapeutic effect. The appointment of any drug depends on the severity of the course of the disease and the individual characteristics of the organism. So, in the intermittent form, you can use both a combined and a single-component agent. However, in the case of a persistent or severe form, it is recommended to take several types of bronchodilators , so the appointment of Berodual is convenient . Due to the good compatibility of its components and potentiation of the effects of each other, the combined drug has a pronounced bronchodilatory effect, while a more intense effect is achieved than when using Salbutamol .
Possible side effects
Both drugs are generally well tolerated and do not lead to significant side effects. The funds can be used for the treatment of pulmonary diseases in both adults and children.
The most common side effects from taking Salbutamol are tremors and headaches. Due to the selective interaction with beta- adrenergic receptors, the drug is safe and in rare cases causes undesirable effects in the form of an increase in angina attacks, an increase in heart rate, arrhythmias when the therapeutic dose is exceeded. Long-term use of the drug can lead to the development of hypokalemia . The ricochet syndrome is very rarely formed, manifested by paradoxical bronchospasm against the background of the formation of metabolites that contribute to the contraction of smooth muscles.
Adverse reactions when taking Berodual are associated with the m-cholinomimetic and beta-2-adrenomimetic actions of the active components. Palpitations, headaches, tremors may occur. In rare cases, hypokalemia and atrial fibrillation develop . Since ipratropium bromide binds to m3-cholinergic receptors, intraocular pressure may increase, and lens accommodation may be disturbed. Glaucoma is very rare. While taking the medication, a dry cough, a sore throat, and less often dysphonia often appear .
Diseases of the respiratory system associated with the development of obstruction are subject to complex treatment. Salbutamol is used to relieve attacks with mild bronchial asthma, COPD, chronic bronchitis. Berodual has a more pronounced effect and is used both in the case of acute bronchospasm and for the prevention of its occurrence.