Ventolin - instructions for use, analogs, reviews and release forms
In this article, you can read the instructions for the use of the drug Ventolin. There are reviews of visitors to the site - consumers of this medication, as well as opinions of specialists in the use of Ventolin in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Ventolin in the presence of existing structural analogues. Use for the treatment of bronchial asthma and chronic bronchitis in adults, children, as well as in pregnancy and lactation.
Ventolin is a selective beta2-adrenergic receptor agonist. In therapeutic doses, it acts on beta2-adrenergic receptors of the smooth muscles of the bronchi, with little or no effect on myocardial beta-1 adrenoceptors. Has a pronounced bronchodilator effect, preventing or arresting bronchospasm, reduces resistance in the airways. Increases the vital capacity of the lungs (ZHEL). Increases mucociliary clearance (with chronic bronchitis to 36%), stimulates the secretion of mucus, activates the functions of the ciliated epithelium.
In recommended therapeutic doses does not have a negative effect on the cardiovascular system, does not cause an increase in blood pressure. To a lesser degree, in comparison with the drugs of this group, it has a positive chrono and inotropic effect. Causes the enlargement of the coronary arteries.
It has a number of metabolic effects: it reduces the concentration of potassium in the plasma, affects glycogenolysis and insulin secretion, has hyperglycemic (especially in patients with bronchial asthma) and a lipolytic effect, increases the risk of acidosis.
After the application of inhalation forms, the effect develops rapidly, the onset of the effect is 5 minutes, the maximum after 30-90 minutes (75% of the maximum effect is achieved within 5 minutes), the duration is 4-6 hours.
Salbutamol sulfate micronized + excipients.
After inhalation, 10-20% of the dose of salbutamol reaches the lower respiratory tract. The rest of the dose remains in the inhaler or is deposited in the oropharynx and then swallowed. The fraction deposited in the respiratory tract is absorbed into the lung tissue and blood, but not metabolized in the lungs.
The swallowed portion of the inhalation dose is absorbed from the gastrointestinal tract and subjected to intensive metabolism during the "first passage" through the liver, turning into an inactive 4'-O-sulfate (phenolic sulfate).
The binding of salbutamol with plasma proteins is 10%. It is excreted partially by the kidneys in unmodified form and partly in the form of inactive 4'-0-sulphate (phenolic sulfate), which is also excreted mainly in the urine. Only a small part of the administered dose of salbutamol is excreted with feces. Most of the dose of salbutamol administered intravenously, orally or by inhalation, is excreted within 72 hours.
- relief of attacks of bronchial asthma, incl. with exacerbation of severe bronchial asthma;
- prevention of attacks of bronchospasm associated with exposure to an allergen or caused by physical exertion;
- application as one of the components with prolonged maintenance therapy of bronchial asthma.
Chronic obstructive pulmonary disease (COPD), accompanied by reversible airway obstruction, chronic bronchitis.
Forms of release
Aerosol for inhalation is dosed (sometimes mistakenly called a spray).
Solution for inhalation in nebulas in ampoules (Ventolin Nebula) (sometimes mistakenly called syrup).
Instructions for use and dosage
The drug Ventolin is intended only for inhalation. The increased need for the use of beta2-adrenoreceptor agonists may be a sign of aggravation of bronchial asthma. In such a situation, a reassessment of the patient's treatment regimen may be required, with consideration of the advisability of prescribing concurrent therapy with GCS.
Since an overdose can be accompanied by the development of adverse events, the dose or multiplicity of the drug may be increased only on the advice of a doctor.
The duration of action of salbutamol in most patients is from 4 to 6 hours.
In patients experiencing difficulty in inspiratory synchronization using a metered aerosol inhaler under pressure, a spacer can be used.
In children and infants who receive the drug Ventolin, it is advisable to use a pediatric spacer device with a facial mask.
For relief of an attack of bronchospasm to adults, the recommended dose is 100 or 200 ?g; Children - 100 mcg, if necessary, the dose can be increased to 200 mcg. It is not recommended to use Ventolin inhaler more often 4 times a day. The need for frequent use of maximum doses of the drug Ventolin or in a sudden increase in dose indicates a worsening of the course of asthma.
To prevent bouts of bronchospasm associated with exposure to an allergen or caused by physical exertion, adults - 200 mcg for 10-15 minutes before the impact of a provoking factor or load; children - 100 mcg for 10-15 min before exposure to a provoking factor or load, if necessary, the dose may be increased to 200 mcg.
With prolonged maintenance therapy for adults - up to 200 mcg 4 times a day; children - up to 200 mcg 4 times a day.
Rules of application of the inhaler
Checking the inhaler
Before using the inhaler for the first time, or if the inhaler has not been used for a week or longer, remove the cap from the mouthpiece by squeezing the cap slightly on the sides, shake the inhaler well and spray two into the air to make sure the inhaler is working.
Use of an inhaler
- Remove the cap from the mouthpiece by slightly squeezing the cap from the sides.
- Inspect the mouthpiece from the inside and outside to make sure it is clean.
- Shake the inhaler well.
- Keep the inhaler between the index and thumb in an upright position with the bottom up, with the thumb on the base under the mouthpiece.
- Make a slow deep exhalation, grasp the mouthpiece with your lips, without squeezing it with your teeth.
- With the deepest inhalation through the mouth, simultaneously press the upper part of the inhaler to release one inhalation dose of salbutamol.
- Hold your breath for a few seconds, take out the mouthpiece from your mouth, then slowly exhale.
- For the second dose, while holding the inhaler in an upright position, wait about 30 seconds and then repeat the procedure. 3-7.
- Close the mouthpiece firmly with a protective cap.
Performing stages 5, 6 and 7, you can not hurry. Start inhaling as slowly as possible, just before pressing the inhaler valve. In the first few times it is recommended to practice before the mirror. If you see a "fog" coming from the top of the inhaler or from the corners of the mouth, you should start all over again from stage 2.
If the doctor gave other instructions for using the inhaler, the patient must strictly observe them. If the patient has difficulty using an inhaler, then he needs to see a doctor.
Cleaning the inhaler
The inhaler should be cleaned at least once a week.
- Remove the metal can from the plastic casing and remove the lid of the mouthpiece.
- Thoroughly rinse the plastic casing and lid of the mouthpiece under a stream of warm water.
- Dry the plastic housing and the mouthpiece cover completely both outside and inside. Do not overheat.
- Place the metal can in the plastic casing and put on the lid of the mouthpiece.
Do not immerse the metal can into the water.
Applied inhalation. The drug Ventolin Nebula is not intended for injection.
The drug Ventolin Nebula should be used under the supervision of specialists with a special nebulizer with a mask, T-tube or endotracheal tube. In case of risk of hypoxia due to hypoventilation, the inhaled air can be enriched with oxygen.
Ventolin Nebula is intended for use in undiluted form, however, if long-term administration of salbutamol solution is required (more than 10 minutes), the drug can be diluted with a sterile 0.9% sodium chloride solution. The solution left unused in the nebulizer chamber after inhalation should be poured.
Because many nebulizers operate only in the presence of a constant flow of air, it is possible that the sprayed drug will enter the environment. Given this, Ventolin Nebula should be used in well-ventilated areas; this recommendation should be strictly observed in hospitals, where several patients can simultaneously use nebulizers.
Adults and children over 1.5 years of age
The average initial dose of salbutamol administered by inhalation with a nebulizer is 2.5 mg, but can be increased to 5 mg. Inhalation can be repeated 4 times a day. For the treatment of severe airway obstruction, adult patients can use the drug at higher doses - up to 40 mg per day - under strict medical supervision in a hospital.
- arrhythmias (including atrial fibrillation, supraventricular tachycardia and extrasystole);
- peripheral vasodilation;
- paradoxical bronchospasm;
- irritation of the mucous membrane of the oral cavity and pharynx;
- muscle cramps.
- preterm delivery;
- threatening abortion;
- hypersensitivity to the components of the drug.
Application in pregnancy and lactation
In pregnancy, Ventolin is prescribed only in cases where the expected benefit of therapy for the mother exceeds the potential risk to the fetus.
In the course of post-registration follow-up, rare cases of various developmental malformations in children, including the formation of "wolf mouth" and developmental limbs, were detected against the background of taking salbutamol during pregnancy. In some of these cases, mothers took several concomitant medications during pregnancy. Due to the lack of a permanent nature of defects and the background frequency of congenital anomalies, ranging from 2 to 3%, the cause-and-effect relationship with taking the drug has not been established.
Salbutamol probably penetrates into breast milk, and therefore it is not recommended to prescribe it to nursing women, unless the expected benefit for the patient outweighs the potential risk to the child. There is no evidence of whether the salbutamol present in breast milk has a deleterious effect on the newborn.
Use in children
Contraindicated in children under 2 years of age for aerosol (up to 1.5 years for Nebula).
Treatment of bronchial asthma is recommended to be carried out step by step, controlling the patient's clinical response to treatment and lung function,
Bronchodilators should not be the only or main component of asthma therapy for unstable or severe flow.
The increased need for the use of bronchodilators with short duration of action, in particular beta2-adrenoreceptor agonists, to control the symptoms of bronchial asthma indicates a worsening of the course of the disease. In such cases, the patient's treatment plan should be reviewed. Sudden and progressive deterioration of bronchial asthma can pose a potential threat to the life of the patient, so in such situations, the advisability of prescribing or increasing the dose of corticosteroids should be considered. In patients at risk, daily monitoring of peak expiratory flow is recommended.
Therapy with beta2-adrenergic agonists, especially when administered by parenteral or with a nebulizer, can lead to hypokalemia.
Particular caution should be exercised in the treatment of severe attacks of bronchial asthma, because in these cases, hypokalemia can be exacerbated by the simultaneous use of xanthine derivatives, corticosteroids, diuretics, and also due to hypoxia. In such situations it is recommended to monitor the potassium level in the blood serum.
If there is no effect on the previously effective dose of inhaled salbutamol for at least 3 hours, the patient should consult a doctor for any additional measures.
Patients should be instructed about the proper use of the Ventolin inhaler.
Impact on the ability to drive vehicles and manage mechanisms
It is not recommended to simultaneously use salbutamol and nonselective beta-adrenoreceptor blockers, such as propranolol.
Salbutamol is not contraindicated in patients who receive MAO inhibitors.
In patients with thyrotoxicosis, Ventolin enhances the effect of CNS stimulants, tachycardia.
Theophylline and other xanthines, when used concomitantly with Ventolin, increase the likelihood of tachyarrhythmia.
Simultaneous administration with anticholinergics (including inhalation) may help increase intraocular pressure.
Diuretics and glucocorticosteroids (GCS) increase the hypokalemic effect of salbutamol.
Analogues of the drug Ventolin
Structural analogs for the active substance:
- Ventolin Nebula;
- Cibutocaps Cibutocaps.
Analogues on the curative effect (agents for the treatment of asthma):
- Libexin Muko;
- The mukonist;
- Pulmicort Turbuhaler;
- Seredid Multidisk;