Bronchodilator drugs in the form of metered aerosols, tablets, complex mixtures are used most widely in the treatment of asthma, and it is they that cause the greatest number of side effects. First of all, these are heart rhythm disturbances (palpitations, feeling of interruptions); the appearance of difficulty breathing after taking certain drugs, as well as discomfort behind the sternum; hoarseness and dry mucous membranes.
Of the metered-dose bronchodilators , the most frequent heartbeat per inhalation of a single dose of the drug is caused by Atrovent. and its analogues.
First, because of the relatively higher dose (compared to other aerosols), and second, because of the stimulating effect on the myocardium. As already mentioned, when a heartbeat on any aerosol appears, you should choose another inhaler.
If, when replacing one aerosol with another, the heartbeat does not decrease, it is necessary to consult a doctor.
If you feel heart failure due to the use of bronchodilator aerosols, you should also consult a doctor, as this may be a manifestation of cardiac pathology. In this regard, you should always remember that in the presence of cardiovascular diseases, treatment with bronchodilator drugs in the form of tablets and mixtures ( teofedrin , broncholitin, solutan , theophylline, etc.) should be carried out only by prescription and under the control of a doctor!
The emergence of breathing difficulties on the inhalation of bronchodilator aerosols is observed mainly on the drugs Atrovent and its analogues. This is due to their slower bronchodilatory action (the maximum effect is achieved only after 30–50 minutes) and the occurrence of reflex bronchospasm in response to inhalation of the aerosol. You can avoid this by combining drugs Atrovent and its analogues with more “fast” bronchodilator aerosols – salbutamol .
If such an attempt is ineffective, replace it with salbutamol .
Often there are difficulties in breathing bronchodilator drugs in the form of tablets or mixtures. In such cases, you should immediately consult a doctor, as this indicates that the situation is out of control. By the way, many patients and even doctors attribute the difficulty of breathing on these drugs to the category of allergic reactions – this is a delusion.
As for other side effects: hoarseness, unpleasant sensations behind the sternum ( soreness , burning) and dry mucous membranes, these reactions, apart from discomfort, do not pose any danger. They usually occur when using Atrov ent (and other means) and are associated both with the action of the medicinal substance itself and with local irritation of the mucous with the carrier gas of the aerosol. It is possible to eliminate these unpleasant sensations by introducing a small amount of vegetable oil into the upper respiratory tract (5-10 drops 2-3 times a day) by instillation into the nose. The procedure is very simple: lifting your head up, put oil in your nose, and then, without haste, make 10-15 deep calm breaths (inhale through the nose, exhale through the mouth).
In the process of breathing, part of the oil will fall on the mucous membranes of the larynx and trachea, and the discomfort in a few days will disappear. An even more effective way to eliminate hoarseness is to inhale the vapors of essential oils with the help of a Mahold inhaler (or the like). The inhaler is a small glass reservoir for the essential oil and a system of tubules. The inhaled air, passing through them, is enriched with volatile essential oil, softens the mucous membrane of the larynx, and hoarseness disappears.
Side effects of hormonal and anti-allergic drugs
Side effects of hormonal drugs can be divided into systemic (general) and local. As already mentioned, anti-inflammatory hormonal drugs (for example, prednisone) are derived from human own hormones involved in the regulation of metabolism.
And since they are applied in doses exceeding physiological, their action causes systemic complications.
Systemic complications are associated, as a rule, with the intake of tablet preparations and are manifested by weight gain, impaired fat metabolism (redistribution of adipose tissue on the face, limbs and body), exacerbation of gastrointestinal diseases and a number of other problems.
Immediately I want to say that when side effects of hormone therapy appear, you should immediately contact a specialist in the treatment of bronchial asthma – an allergist or pulmonologist – to select the optimal treatment regimen, because in most cases all problems arise from the irrational use of these drugs.
It is believed that, in contrast to hormone tablets , drugs intended for inhalation – local use, even with the introduction of the inside cause a minimal systemic effect. For example, the local anti-inflammatory effect of beclomethasone is 500 (!) Times higher than that of prednisone, and its systemic action when inhaled is higher than that of prednisone only 6 times.
Therefore, in doses up to 600–800 micrograms per day, inhalation hormonal preparations usually cause only local complications. But, unfortunately, as a result of the next “revision” of views on the treatment of asthma (I mean all the same report “Global Strategy …”), the recommended dose of these drugs exceeds 1000 or more micrograms. In this case, they also cause systemic complications. But we will talk about this in the last part of the book.
Local side effects are manifested by hoarseness, unpleasant sensations behind the sternum (burning sensation), the development of fungal lesions of the oral cavity and upper respiratory tract (mainly candidiasis). These phenomena quickly disappear when instillation of oil into the nose, as recommended above. Inhalations in the form of powder from capsules can be replaced by similar preparations and in the form of metered aerosols .
Sometimes inhalation causes difficulty breathing. This is usually due to its misuse. For the prevention of such reactions, it must be remembered that the inhalation of this drug should be carried out only after the preliminary use of bronchodilator aerosols, for example, salbutamol .
It also contributes to its deeper penetration into the respiratory tract, and hence the most effective action.
Penetration into the smallest bronchi and uniform distribution of the lek in the village rstv yhatelnyh ways will be achieved if the following rules:
1) to carry out inhalation standing;
2) before inhaling the drug, lift the head as much as possible upwards so that the chin looks at the ceiling;
3) the mouthpiece of the spinhaler tightly clasp his lips and at the same time ensure that the opposite end (bottom) of the spinhaler is also directed upwards. With such a position of the turbo inhaler, the penetration and distribution of the powdered drug will also be improved under the action of gravity.
In passing, I note that at present, most of the drugs — bronchodilatory , anti-inflammatory, and antiallergic — are beginning to be produced precisely in the form of a powdered aerosol, and when using these drugs you must also adhere to these rules.
As for candidiasis, its effective prophylaxis and treatment is achieved by rinsing the mouth and throat with weak solutions of potassium permanganate (pink solution), and odious potassium (0.5–1% solution) .
But when using large doses of steroids (I have already spoken about this), severe forms of candidiasis may develop, requiring the appointment of a special antifungal treatment. Side effects of other drugs and more detailed information are given in the annotations to each of them, which, in fact, you only need to know the doctors. In conclusion, once again I want to repeat the two most important tips for all patients with asthma: