Index of drugs

Treatment of asthmatic conditions. Treatment of acute bronchoconstriction in chronic obstructive pulmonary disease and asthma that can not be cured by usual treatments.

2.5 ml of the nebuliser solution (single-dose container) contains 2.5 mg or 5 mg of Salbutamol (as sulphate).

Selective β₂- short-term (4-6 h), fast-acting (within 5 min) bronchial dilation in the case of reversible obstruction of the airways. In therapeutic doses, it stimulates β receptors₂-renergic in the smooth muscles of the bronchi. Due to its rapid onset of action, it is recommended for the treatment of asthma attacks. After inhalation 10-20% of the dose reaches the lower respiratory tract. The remaining part stays in the mouth and throat, is swallowed, absorbed from the gastrointestinal tract and undergoes the metabolism of the first passage to phenolic sulfate. The drug that has reached the airways is absorbed in the pulmonary parenchyma and enters the circulation (it is not metabolized in the lungs), with the general circulation gets into the liver, it is metabolized to phenolic sulfate. Both salbutamol in unchanged form and metabolite are mainly excreted in the urine.

Hypersensitivity to Salbutamol, other sympathomimetic amines or to any of the excipients. Myocardial infarction. Salbutamol in the form of a solution for nebulization should not be used to prevent miscarriage or premature labor.

Bronchodilators should not be used as the sole or essential for the treatment of patients with severe or unstable asthma. Patients with severe asthma should undergo regular medical check-ups, including lung function assessment, due to the risk of severe asthma attack and even death. In such patients, the maximum recommended dose of inhaled corticosteroid and / or oral corticosteroids should be considered. At the same time, other short-acting inhaled bronchodilators can be used with salbutamol. Increased consumption of bronchodilators, especially short-acting inhaled β₂- in order to alleviate the symptoms, it indicates the deterioration of asthma control. Increasing the dose or frequency of use is only allowed under the supervision of a physician; the patient's condition should be evaluated and the need to increase the dose of anti-inflammatory medications (eg, increasing the dose of inhaled corticosteroids or using an oral corticosteroid) should be considered. Severe asthma exacerbations should be treated in accordance with generally accepted principles. The preparation should be used with caution in patients who have taken high doses of other sympathomimetic medicines. As with other inhaled medications, paradoxical bronchospasm may occur (manifested by wheezing immediately after drug application); in this situation, the use of the preparation should be immediately discontinued and an alternative method of treatment should be used. Solutions with an inert pH may in rare cases induce paradoxical bronchospasm in some patients. Salbutamol and drugs that do not selectively block beta-adrenergic receptors (eg propranolol) should not be used at the same time. Salbutamol should be used with caution in patients with: hyperthyroidism; pheochromocytoma; vascular diseases associated with vascular stenosis; hypertension; coexisting severe cardiac disease, eg ischemic heart disease, cardiac arrhythmia or severe heart failure (risk of exacerbation of heart disease). Due to the risk of acute seizure glaucoma, combined use of salbutamol and anticholinergic agents in the form of nebulisation in patients with suspected or diagnosed glaucoma requires special care (patients should be advised not to get into the eyes). Salbutamol may cause transient metabolic changes (e.g.increase in blood glucose); Patients with diabetes may have difficulty in achieving glycemic control, ketoacidosis may occur; concomitant use of corticosteroids may enhance this effect. Application of β₂-agonists, especially parenterally or in inhalation from a nebulizer, can cause potentially severe hypokalaemia; extreme care should be taken in the event of an acute severe asthma attack, because tissue and organ hypoxia and concomitant treatment with xanthine derivatives, steroids and diuretics may exacerbate hypokalemia; in these situations, the concentration of potassium in the blood should be monitored.

During pregnancy, use only in cases where the expected benefit to the mother outweighs the possible risk to the fetus. Salbutamol can be excreted in human milk; it is not known whether it has a detrimental effect on a newborn baby.

Common: tremor, headache, tachycardia. Uncommon: palpitations, irritation of the mucous membranes of the mouth and throat. Rare: excessive activity (in children), expansion of peripheral blood vessels, muscle cramps. Very rare: hypersensitivity reactions (including angioneurotic edema, urticaria, bronchospasm, hypotension, collapse), cardiac arrhythmia (including atrial fibrillation, supraventricular tachycardia and additional myocardial contractions), paradoxical bronchospasm. Not known: hypokalemia, myocardial ischemia, increased heart rate (usually no change in ECG).

Inhalant, in the form of nebulization. Adults (also elderly patients) and children> 2 years: 2.5 mg 3-4 times a day. In closed health care, 5 mg 3-4 times a day can be used under strict control. Because of the possibility of transient hypoxia, the use of oxygen therapy should be considered.
The preparation should be used undiluted. When inhaling for more than 10 minutes, a 0.9% NaCl solution can be used to dilute the drug. The nebulizer solution can be used by a face mask or T-shaped hose.