Spray for asthma cross running sport. Berserk (combat pharmacology): salbutamol. What medications are used in inhalers?

Doping for testing. 12 drugs from the pharmacy that are prohibited in sports

Match TV tells what popular drugs athletes should avoid in order to avoid quarreling with WADA.

Cardionate

Release form: capsules

Price: from 200 rubles (capsules 250 mg, 40 pieces)

Conditions for dispensing from the pharmacy: over the counter

Indications for use. Protects the heart in conditions of oxygen starvation, helps cope with the consequences of heart attacks and strokes. In some cases, it is used to treat alcoholism (in combination with specific therapy).

Status in sports. The main active ingredient is meldonium, because of which Maria Sharapova, Yulia Efimova, Pavel Kulizhnikov, Semyon Elistratov and a little more than a hundred athletes from different countries and disciplines were temporarily suspended from competitions.

Meldonium has been banned since January 1, 2016. It was classified as a hormone and metabolic modulator and was banned both in and out of competition.

You can find meldonium not only in Mildronate or Cardionate. It is also contained in Angiocardil, Vazomag, Vasonat, Indrinol, Medatern, Melfor, Midolat, Mildroxin, Trizipine, Trimedronate. And this is not a complete list.

Relief Ultra

Release form: candles

Price: from 500 rubles (candles, 12 pieces)

Conditions for dispensing from the pharmacy: over the counter

Indications for use. Medicine for hemorrhoids.

Status in sports. Relief Ultra contains hydrocortisone, which belongs to the class of glucocorticoids and is prohibited for use both at competitions and during preparation for them.

Glucocorticoids are hormones that are produced by the adrenal glands and in some cases can be used to increase body weight and strength. But what worries WADA experts most of all is not this, but the side effects from the use of such substances, including obesity and diabetes.

There is an important clarification: only substances that are used orally, intravenously, intramuscularly or rectally are prohibited. The last method is just relevant in the case of Relief Ultra. At the same time, the earlier version of the drug – “Relief” – does not contain prohibited substances.

Rinofluimucil

Release form: nasal spray

Price: from 220 rubles (10 ml bottle)

Conditions for dispensing from pharmacies: over the counter

Indications for use. One of the most popular medicines for the common cold and its complications - sinusitis and sinusitis. Quickly thins mucus, has an anti-inflammatory effect and eliminates swelling of the mucous membrane.

Status in sports. Among the components of Rinofluimucil is tuaminoheptane. The substance was included in the list of prohibited substances back in 2009. WADA classifies it as a stimulant and warns that too frequent use may be harmful to the cardiovascular system.

Before the 2010 Olympics, traces of tuaminoheptane were found in the blood of Russian hockey player Svetlana Terentyeva. The athlete was able to prove that she used Rinofluimucil to treat a cold, and the case ended with a reprimand. French basketball player Joseph Gomis was less fortunate - he was disqualified in 2013 for six months. And the Belarusian cyclist Tatyana Sharakova was immediately suspended from competition for 18 months.

Adelfan-Ezidrex

Release form: pills

Price: from 130 rubles (30 tablets)

Conditions for dispensing from the pharmacy: on prescription

Indications for use. Prescribed for hypertension - a persistent rise in blood pressure, especially in cases where the exact causes of the disease cannot be identified.

Status in sports. The hydrochlorothiazide contained in the composition is a diuretic. These substances reduce the amount of fluid in tissues. In some cases, they may be used for other purposes – for weight loss. At the same time, they also increase the excretion of sodium, potassium and chlorine and, with prolonged use, can disrupt the acid-base balance in the body. WADA considers this sufficient grounds to ban them from the sport.

Fenotropil

Release form: pills

Price: from 370 rubles (100 mg tablets, 10 pieces)

Conditions for dispensing from the pharmacy: on prescription

Indications for use. Nootropic drug. Widely used in the treatment of diseases of the central nervous system, especially in cases where deviations are associated with metabolic disorders in the brain. In addition, the drug improves memory, increases concentration and even helps fight obesity.

Status in sports. WADA specialists have had questions about Phenotropil, or more precisely about its component, fonturacetam (better known as carphedon), for a long time. By January 2000, they were able to prove that this substance is capable of having a pronounced stimulating effect on motor reactions and increasing physical performance.

The most notorious story related to its use happened at the Olympic Games in 2006. Then traces of the stimulant were found in the doping test of Russian biathlete Olga Pyleva (after marriage - Medvedtseva). As a result, Pyleva was deprived of Olympic silver in the 15 km individual race and disqualified for two years, and doctor Nina Vinogradova, who prescribed her phenotropil without coordinating this with the team doctors, was deprived of the right to work with athletes for 4 years.

Kenalog

Release form: suspension for injection; pills

Price: from 300 rubles (4 mg tablets, 50 pieces); from 500 rubles (ampoules 40 mg/ml, 5 pieces)

Conditions for dispensing from the pharmacy: on prescription

Indications for use. Kenalog has a fairly wide spectrum of action. In tablet form, it may be prescribed to treat asthma or bronchitis. And injections help cope with inflammatory joint diseases. In addition, it can be effective in the fight against psoriasis and various dermatitis.

Status in sports. The active ingredient of the drug, triamcinolone, belongs to the class of glucocorticoids. And in this case, it is especially important which method of use the doctor chooses. The use of these substances orally, intravenously, intramuscularly or rectally in sports is strictly prohibited. At the same time, WADA does not object to the nasal, intra-articular, periarticular and local use of glucocorticoids and drugs based on them.

Zenhale

Release form: aerosol for inhalation

Price: from 1200 rubles (120 doses)

Conditions for dispensing from the pharmacy: on prescription

Indications for use. Most often used as maintenance therapy for bronchial asthma.

Status in sports."Zenhale" is a complex combination drug. It contains several substances from the WADA list. For example, one of the active ingredients, mometasone furoate, belongs to the class of glucocorticoids. They are prohibited, but with certain reservations and concessions, among which inhalation use is relevant for Zenhale.

Another component of the drug is formoterol. It belongs to the class of beta-2 agonists. These substances stimulate adrenergic receptors. In this case, those that are in the bronchi. As a result, the bronchi expand and bronchial patency improves. Taking this into account, WADA specialists decided to limit the dose of formoterol to no more than 54 mcg/day. One dose of Zenhale contains 5 mcg of the substance. Thus, an athlete can afford no more than 10 injections of the drug per day. At the same time, it is always necessary to indicate in the doping control report when and in what quantities Zenhale was used. These rules and restrictions apply to all medications for asthma and most drugs prescribed for the treatment of bronchopulmonary diseases, including pneumonia.

Diakarb

Release form: pills

Price: from 250 rubles (250 mg tablets, 24 pieces)

Conditions for dispensing from the pharmacy: on prescription

Indications for use. Diuretic. Helps cope with edema and the consequences of acute “altitude” illness (reduces acclimatization time). In addition, it is used to relieve acute attacks of glaucoma.

Status in sports. Strictly speaking, it is not doping. But due to its pronounced diuretic properties, it helps to quickly remove traces of prohibited substances. For such drugs, the WADA blacklist has a separate class - masking agents. Their presence, albeit indirectly, indicates doping.

Insulin

Release form: solution or suspension in special cartridge systems (cartridges, sleeves and syringe pens) or vials

Price: from 500 rubles (injection solution, 9 ampoules)

Conditions for dispensing from the pharmacy: on prescription

Indications for use. Diabetes mellitus type I. Insulin is the most important regulator of carbohydrate metabolism.

Status in sports. It is most widespread in bodybuilding, especially in combination with anabolic steroids, which accelerate the formation and renewal of the structural parts of cells and muscles. WADA specialists have long paid attention to such properties of insulin, as well as its ability to speed up metabolism and increase endurance, and added it to the prohibited list (class - metabolic modulators).

All diabetics undergo mandatory WADA registration, after which they receive the right to use insulin. For others, the drug is strictly prohibited.

Trimetazidine

Release form: pills

Price: from 120 rubles (20 mg tablets, 60 pieces)

Conditions for dispensing from the pharmacy: on prescription

Status in sports. Placed on the WADA Prohibited List in 2014. Agency specialists initially classified it as a stimulant and prohibited its use only during competitions. But in 2015 they revised their attitude and transferred it to the class of hormones and metabolic modulators. These substances are always prohibited in sports.

Trimetazidine has many analogues. The most common: Antisten Triductan MV, Deprenorm, Carmetadine Trimectal, Carditrim Trimed and Preductal.

Reamberin

Release form: solution for infusion

Price: from 150 rubles (250 ml polymer container)

Conditions for dispensing from the pharmacy: on prescription

Indications for use. Normalizes the acid-base balance and gas composition of the blood, promotes the removal of bile acids, toxins and metabolic products.

Status in sports. The drug itself is not prohibited in sports. WADA is not satisfied with the method of its administration – intravenous injection. At the request of the Anti-Doping Agency, intravenous injections are allowed only if their volume does not exceed 50 ml, and the interval between them is at least 6 hours. And the daily dose of Reamberin for adults reaches 800 ml.

Clenbuterol

Release form: syrup and tablets

Price: from 320 rubles (20 mcg tablets, 50 pcs); from 110 rubles (syrup 1 mcg/ml, bottle 100 ml)

Conditions for dispensing from the pharmacy: over the counter

Indications for use. Widely used in the treatment of bronchial asthma and chronic obstructive pulmonary diseases.

Status in sports. Clenbuterol actively affects adrenergic receptors and improves breathing. In addition, there are studies that confirm that clenbuterol stimulates muscle growth. WADA classifies it as an anabolic agent and prohibits its use both during competitions and in preparation for them. Despite this, traces of the substance are often found in athletes’ doping samples. Thus, the Spanish cyclist Alberto Contador lost his victory at the 2010 Tour de France and the 2011 Giro D’Italia precisely because of such a test. At the same time, his colleague, Australian Michael Rogers, was able to prove that doping entered his body along with meat - farmers also use clenbuterol. This is most often done in Mexico. WADA research has found that approximately 75% of local meat contains traces of this banned substance.

Text: Marina Krylova

Photo: globallokpress.com, Getty Images

Find out how to choose an asthma inhaler for running. Classification, action for complex treatment and which ones are better and more convenient.

Inhalers for bronchial asthma: names and which ones are best for asthmatics?

Bronchial asthma is a disease characterized by inflammation in the bronchi, which causes the latter to become hypersensitive to various irritants.

For asthmatics, a prolonged attack that is not stopped in time with a special drug can be fatal. There are drugs for bronchial asthma with different mechanisms of action and release forms, but many of them have a sufficient number of side effects.

The tablets have a generalized effect and negatively affect the liver and kidneys, take a long time to act, and cannot be given to the patient during an attack. Injections must be performed by a person with certain skills and under sterile conditions.

Attention!

Inhalers at the moment allow you to use them anywhere, carry them with you, and their effect due to the localization of the substance is much faster and stronger than other dosage forms.

Therefore, today the choice most often leans towards the most modern method of administering medication for asthma, which has the fewest disadvantages - inhalation.

What asthma inhalers are currently available in medicine? What are their advantages and disadvantages? How to choose the best inhaler on the market and how to use them correctly? Read about all this further in the article.

Types of inhalers

Initially, inhalers were bulky structures that were not possible not only to carry with you, but also to have them outside of medical institutions.

Today there are several types of inhalers.

Source: http://OPnevmonii.ru/astma/terapiya-03/ingalyatory-dlya-astmatikov.html

Inhalers for bronchial asthma: names and prices of drugs

For asthma, stepwise therapy is prescribed. It involves the inclusion of an increasing number of drugs in the treatment depending on the severity of the disease. A significant portion of medications are administered directly into the respiratory tract using inhalers.

The article will discuss which inhalers can be prescribed for asthma. We also provide a table of trade names and approximate prices for these medications.

In the treatment of asthma, two fundamentally different directions are used: basic and symptomatic therapy. Basic therapy agents have an anti-inflammatory effect and are designed to stabilize the course of the disease. With the right choice, asthma control can help you get rid of attacks or reduce their number.

If basic therapy is not effective enough, asthma attacks or coughing occur. In these cases, quick-acting medications that dilate the bronchi come to the rescue. They have no therapeutic effect, but they quickly alleviate the symptoms of the attack.

Inhalers used in basic asthma therapy

A metered dose aerosol inhaler is the simplest device.

For regular use, your doctor may prescribe one or more of the following:

• inhaled glucocorticoids (ICS);
• Cromons;
• combined products that include several components at once.

Another group of drugs for basic therapy - leukotriene receptor antagonists - is available in the form of tablets for oral administration.

Inhaled glucocorticoids

This is the basis of basic therapy. In most cases, asthma cannot be avoided without regular use of these drugs.

Aerosol for asthma

Treatment drugs can be divided into two groups.

1. Emergency medications. These include:

Salbutamol (Ventolin)

Available in tablet form, syrup, ampoules and metered dose inhaler. One dose of the inhaler contains 0.1 mg of active substance.

Pharmacokinetics and pharmacodynamics: the drug stimulates β2 receptors of blood vessels, muscle fibers of the bronchi, uterus and causes their relaxation.

During inhalation use of the drug, its effect is selective - exclusively on β2 receptors in the bronchioles and larger bronchi.

In addition to constricting the bronchi, salbutamol reduces capillary permeability and the release of inflammatory mediators, and also stimulates the synthesis of surfactant.

The bioavailability of the drug is low - when used inhalation, 10% reaches the lower respiratory tract. The drug begins to act after 4-5 minutes, the maximum concentration and effect of the drug is observed after 30 minutes, and the duration of the effect is 4-5 hours. Excreted mainly by the kidneys.

Contraindications to the use of salbutamol: there are no absolute contraindications; relative precautions include hyperthyroidism, arterial hypertension, paroxysmal tachycardia, pheochromocytoma.

Side effects: skin rash, dyspeptic syndrome, headache, tinnitus, insomnia, arrhythmias.

Doses and methods of using the drug: inhalation aerosol is used for children over twelve years of age to eliminate bronchospasm 0.1 mg (1 dose of the drug), and for adults - 0.2 mg (2 doses). For preventive measures, the same doses are used.

Overdose: tremor, palpitations, and increased systolic pressure are possible.

Interaction with other drugs: cannot be used with non-selective beta-blockers. They potentiate the effect of drugs that stimulate the central nervous system and anticholinesterase drugs.

Storage conditions: shelf life – 2 years. Store at a relative temperature no higher than 28 degrees, avoiding direct exposure to high and low temperatures.

Fenoterol (Partusisten, Berotec, Berodual)

Available in tablets, ampoules, inhalation aerosols of 15 ml containing 300 doses, 1 dose - 0.2 mg.

Pharmacokinetics and pharmacodynamics: the drug stimulates β2 receptors of the bronchi, uterus, blood vessels and causes their relaxation. During inhalation use of the drug, its effect is selective - exclusively on β2 receptors of the bronchi.

In addition to pronounced bronchodilation, it increases the functioning of the cilia of the ciliated epithelium of the bronchoalveolar tree. The drug begins to act 3-6 minutes after use, the maximum concentration of the drug is 40-80 minutes, and the duration of action is 3.5-6 hours.

Fenoterol is metabolized by liver enzymes and excreted in the urine through the kidneys.

Contraindications to the use of Formoterol: tachyarrhythmias, hypertrophic or dilated cardiomyopathy, excessive genetic sensitivity to the components of the drug, hypertension or secondary hypertension, pheochromocytoma, diabetes mellitus, chronic cardiac failure.

Side effects: urticarial elements on the skin, anaphylactic shock, Quincke's edema, collapse with arterial hypotension. Dyspeptic symptoms, vascular and neurogenic pain, pain and twitching of small muscles, arrhythmia, and fibrillation may be observed.

Doses and methods of using the drug: adult patients and children after six years should be prescribed about 0.2 mg of the active substance (1 dose-1 aerosol inhalation) to eliminate bronchospasm; if ineffective, then inhalation can be repeated after 7 minutes. You can take it no more than four times per day. Prophylactic doses are the same as therapeutic ones.

Overdose: possible phenomena of tremor, tachycardia, increase in systolic pressure.

Interaction with other drugs: Fenoterol is not recommended for use with antidepressants and MAO inhibitors, due to the increased risk of collapse in this case. Combination with other bronchodilators threatens the development of rebound syndrome.

Storage conditions: shelf life – 2 years. Store at a relative temperature below 27, away from direct fire, avoid infrared rays, and do not expose to low or high temperatures.

Ipratropium bromide (Atrovent)

Available in the form of injection bottles and 10 ml aerosol, which is 200 doses. 1 dose of aerosol contains 0.2 mg of active substance.

Pharmacokinetics and pharmacodynamics: the drug blocks M-cholinergic receptors of the tracheobronchial tree and in this way promotes the expansion of smooth muscle bronchi. The drug also reduces the secretion of the bronchial glands, acts on the vagus nerve and prolongs the relaxing effect.

When administered via inhalation, bioavailability is no more than 10%. The effect occurs 6-15 minutes after application, the maximum effect is achieved after 1 hour, and the duration of its action is 6 hours, sometimes about 8 hours.

Ipratropium bromide is metabolized by liver enzymes and excreted by the intestines.

Contraindications to the use of ipratropium: the drug is not taken in case of excessive genetic sensitivity to its components, as well as to atropine, congenital pathologies of the bronchopulmonary system (cystic fibrosis). Not prescribed for prostate hyperplasia, urinary system disorders, glaucoma.

Side effects: dyspepsia in the form of nausea, vomiting, dry mouth, decreased intestinal motor-evacuation function.

Attention!

Changes in the pulmonary system - thickening of sputum, cough, laryngospasm, paradoxical bronchospasm, burning of the nasal mucosa.

Allergic manifestations may be observed in the form of urticarial elements on the skin, swelling of the tongue, anaphylactic shock, high blood pressure, palpitations, arrhythmia.

Doses and methods of using the drug: for children six to twelve years old, 0.2-0.4 mg (1-2 doses, which corresponds to 1-2 inhalations) is used to eliminate bronchospasm. For older children and adults – 0.4-0.6 mg (2-3 doses).

The drug should not be used more than 5 times within 24 hours.

For the prevention of asthmatic attacks before any physical activity or possible exposure to an allergen, this drug is not recommended, as it has many different precautions and undesirable effects.

Overdose: no specific changes were detected when the dose of the drug was exceeded. Possible increased side effects, spasm of accommodation, arrhythmia, dryness of the oral epithelium, disruption of normal swallowing.

Interactions with other drugs: when used with short-acting β2-agonists, synergism and increased effect are possible, as well as a sharp deterioration in the patient’s condition with concomitant glaucoma. When used simultaneously with antidepressants, the latter potentiate the effect of Atrovent.

Storage conditions: Ipratropium bromide is valid for 2.5 years. It should be stored at a temperature no higher than 27 degrees, not exposed to low temperatures, and avoid exposure to infrared rays.

1. Drugs for the basic treatment of asthma

Budesonide (Pulmicort)

Available in the form of capsules, spray, ointment, ampoules and aerosol. Metered aerosol consists of 200 doses, 1 dose – 0.2 mg of budesonide. There is a release form of Mite - 1 dose of 0.05 mg.

Pharmacokinetics and pharmacodynamics: the drug is a representative of inhaled corticosteroids, which exhibit a pronounced bronchodilator effect due to intense anti-inflammatory action.

The drug acts on inflammatory cells, inhibits their action, reduces the number of inflammatory cytokines, increases the synthesis of anti-inflammatory proteins, and reduces the number of T cells.

It initiates the work of epithelial cells and mucociliary clearance increases, the number of adrenergic receptors also increases.

The bioavailability of the drug via inhalation route is about 25%. The maximum concentration is reached after 15-45 minutes. The pronounced effect of the drug occurs only with a course of use after 5-6 days.

Contraindications for the use of Budesonide: There are no specific absolute contraindications to treatment with Budesonide. It is not recommended to use the aerosol during lactation, in the case of tuberculosis, fungal infections of the oral cavity, or hereditary intolerance to the components of the active substance.

Side effects: regional local manifestations in the form of dry mouth, hoarseness, burning throat, cough, pharyngitis, oral candidiasis, nausea

Doses and methods of administration: during an exacerbation as a basic therapy from 0.4 mg (2 doses) to 1.2 (6 doses), divided into 3 times a day. During initial therapy during the period of remission, minimum concentrations are prescribed - from 0.2 mg to 0.4 mg 2 times a day. For children, taking into account their age, the “mite” form is used from 0.05 to 0.2 mg per day.

Overdose: symptoms of chronic overdose of the drug are the appearance of signs of hypercortisolism in the form of hormonal obesity, thinning of the skin, hirsutism, acne, moon-shaped face.

Interaction with other drugs: when used simultaneously with some antibiotics, the effect of budesonide may be enhanced; when taken together with cardiac glycosides, their effect is enhanced due to hypokalemia; when taken with diuretics, hypokalemia is enhanced.

Storage conditions: store at a relative temperature no higher than 27 degrees, away from flammable objects, avoid exposure to infrared rays, and do not expose to low temperatures. Shelf life – 2 years.

Source: http://ilive.com.ua/health/aerozol-ot-astmy_106868i15828.html

Inhalers for asthma - an effective means of complex treatment

Chronic inflammatory processes in the bronchi, which characterize bronchial asthma, make them hypersensitive to irritation.

Under the influence of a variety of factors, the patient may experience attacks: dust, stuffiness, frost, contact with domestic animals, and even changes in the psycho-emotional background can provoke asphyxia. If in such cases special anti-attack drugs are not immediately used, the outcome can be very disastrous.

Perhaps the best method to combat suffocation is to use special inhalers for bronchial asthma. They are much safer than pills, which have many side effects, and are more affordable than injections because there is no need to call a healthcare professional. Moreover, you can always have a pocket inhaler with you.

In addition to this, asthma inhalers are completely sterile.

In our review, we will explain how to use an inhaler, talk about the features of these devices, tell you which drugs are used for inhalation, which one is better, and share tips on choosing inhalers.

Classification of inhalers

Inhalers are classified based on two main parameters:

• operating principle;
• the substance used.

Based on the principle of action, there are the following types of inhalers for asthma:

• Steam, the effect of which is based on the evaporation of the solution of the medicine used;
• Ultrasonic, working on crushing the drugs used. High-frequency ultrasonic flow from aerosols has a very good effect on the bronchi. But there is also a serious disadvantage: they are not intended for the use of mucolytics, antibacterial and hormonal medications and may fail when used;
• Compressor, considered universal models and combining the qualities of both of the above. Using a built-in compressor, they create aerosol clouds and are capable of atomizing most of the drugs used;
• Electronic mesh with a wide range of medications used, for example, hormonal drugs, essential oils. Inside the device there is a vibrating plate with many meshes through which the solution flows.

We present to your attention a list of inhalers for asthmatics.

Spacers

Spacers are inhalers consisting of metal or plastic valves designed to allow the passage of medication when inhaled. In fact, they are additional chambers attached to the inhaler itself to facilitate the process of taking the medication.

The medication is sprayed only when the patient inhales, so the process does not require much effort or training, and the medication is used quite economically. Due to their ease of use, such devices are popular among children - they have no difficulty in using the spacer correctly.

The disadvantage of such devices is that due to their design features they can hardly be called portable.

Nebulizers

This device has an almost instant therapeutic effect during attacks of the disease, effectively relieving even the most severe symptoms of the disease.

The operating scheme of this type of bronchial asthma inhaler is based on the direct delivery of dispersed particles of the drug to the internal respiratory organs with further local spraying of the drugs to create a relief effect.

The list of nebulizers is quite long, and they themselves are quite varied in shape. For example, devices used for children are produced in the form of brightly colored toys. Scientists have developed an inhaler, the Forest nebulizer, which allows antibiotics to be delivered to the respiratory system.

The downside of these devices is some bulkiness. In addition, the nebulizer, as a rule, does not have batteries inserted - they are used mainly to operate from the power supply.

Liquid inhalers

These devices are characterized by low cost and ease of use. By pressing a button on the inhaler, a liquid solution under pressure is supplied to the spray bottle and the spray is evenly distributed in the bronchi.

Treatment using such devices is somewhat complicated by the fact that inhalation must be synchronized with pressing the button, otherwise the drug will not reach the bronchopulmonary system, settling in the mouth or throat - then an allergy may occur.

It is especially difficult to accustom children to liquid models.

Hormone inhalers

An asthmatic hormonal inhaler is used to relieve inflammation in the bronchi with adrenaline hormones.

It is not only used to effectively stop an attack: such treatment has almost no risk of adverse reactions, has virtually no effect on metabolic processes and does not result in allergic manifestations, moreover, it helps with allergic asthma. At the same time, they allow you to accurately select the required dose.

Powder devices

Their main advantage is their high efficiency and ease of use. This is perhaps the best inhaler for asthma. Unfortunately, it is not cheap compared to other models. This especially applies to portable pocket inhalers in the form of a powder compact, equipped with special indicators showing the powder consumption. They are called a turbo inhaler or turbuhaler.

Types of drugs

The list of medications used to treat bronchial asthma includes two broad groups - bronchodilators and anti-inflammatory drugs.

If the former are used for rapid relief of attacks (for example, uncontrolled nocturnal exacerbations) and have both short-term and long-term effects, then the second group is more suitable for long-term therapy with transfer of the disease to the remission stage.

The first include the family of sympathomimetics, which stimulate bronchial receptors and dilate the lumens of the bronchi. In addition, they have a good metabolic effect.

Glucocorticoid drugs with a complex mechanism of action based on enzyme blockade, which helps relax smooth muscles and achieve a bronchodilator effect, have the best anti-inflammatory functions.

Anti-inflammatory drugs include stabilizers that act on mast cell membranes and block provocateurs of inflammation - biological active substances found in leukocytes. When asthma is not treated with other drugs, it is necessary to prescribe antiimmunoglobulin E.

Operating rules

All anti-asthma inhalers, especially combined models, require approximately the same technique of use: you must refrain from eating and smoking a couple of hours before the manipulation, and be at rest.

The instructions for use, which should be read before starting the process, will indicate how to use the device correctly. The pocket model is slightly different in operation. After removing the cap from the can and shaking the device, you should exhale and take the mouthpiece into your mouth, then, inhaling, press on the can.

After holding your breath for ten seconds, the patient needs to exhale and close the can.

Conclusion

The latest generation inhalers for the treatment of bronchial asthma are highly effective, but their use alone is not enough.

Bronchial asthma involves the use of inhalers in conjunction with complex therapy, including drug treatment, physiotherapy, radiotherapy and other procedures.

If an inhaler does not help with asthma, more serious, mostly inpatient, treatment is needed.

Source: http://ingalyatsii.ru/bolezni/inglyatory-ot-astmy.html

Breathing trainer

An individual breathing simulator is a device for breathing training for the purpose of preventing or treating diseases such as bronchial asthma, chronic bronchitis, emphysema and some others.

Using a breathing simulator, you can also inhale the respiratory tract with oil aerosols and air-steam mixtures.

In addition to the above-mentioned possibilities, the breathing simulator increases the adaptogenic abilities of the body and serves as a means of recovery and rehabilitation in unfavorable environmental conditions.

What is this?

Attention!

The principle of the exercise machine’s effect on the respiratory system is based on the fact that during the training process the amount of inhaled oxygen decreases and the volume of carbon dioxide increases.

This is reminiscent of breathing thin air high in the mountains, when you need to breathe deeply to ensure a sufficient flow of oxygen into the lungs.

The breathing resistance provided by the exercise machine strengthens the respiratory system, just as exercise strengthens muscles.

Asthma, the treatment and prevention of which involves various methods, is not terrible for those who regularly use a breathing simulator, as are many other diseases of the respiratory tract, allergic or otherwise. In addition, you need to know that a slower rhythm and frequency of breathing saves the body's resources, as a result of which the aging process slows down!

Doctors' opinion

This technique, used at home, in combination with preventative measures such as air purifiers, with a minimum of effort, can produce the highest possible effect.

The breathing simulator is very simple and accessible for independent use, and its obvious effect appears after 25-35 days of regular use. At the same time, the daily time spent on working with the simulator is 20-30 minutes.

Breathing simulators have no contraindications for use, are recognized by the medical community and undergo state certification. Among other things, the described devices can significantly reduce the drug load on internal organs.

Protect yourself and your family members with the help of such modern means of prevention, like air humidifiers, ionizers, salt lamps, breathing simulators, etc.

Offers our portal to all users.

You will find with us all the listed devices and many others, you will be able to get advice from an experienced specialist, select, order and pay for the devices and disease prevention products you need.

Source: http://www.allerg.info/articles-static/dihat-trenaj-uber-ot-astmi.html

Peak flow meters and spacers in the treatment of bronchial asthma

Respiratory tract diseases are becoming more and more common in modern environmental conditions. Both adults and children suffer from bronchial asthma today. The appearance of symptoms of bronchial asthma is significantly influenced by a genetic factor - heredity.

At the same time, the risk of bronchial asthma is increased by external factors: the presence of allergens in the air, excessive occupational exposure to dust, harmful gases and fumes, living in areas with unfavorable environmental conditions, frequent use of cheap powder and aerosol cleaning products, and even poor diet. (overweight, lack of vitamins). Modern pharmaceuticals are able to offer a wide selection of drugs for bronchial asthma. But, in addition, there are auxiliary devices that can significantly facilitate self-control and treatment of bronchial asthma, and in some cases they are simply necessary.

Peak flow meter

Today, even healthy people try to monitor their blood pressure and blood sugar levels, but few people know about the need for peak flow measurements.

A peak flow meter is a small hand-held device that allows you to monitor PEF (peak expiratory flow), that is, the speed of air during a forced exhalation after a maximum inspiration. The device is used by doctors to diagnose bronchial asthma and other respiratory diseases.

Today you can buy a peak flow meter and use it at home for self-monitoring. How to use a peak flow meter? Readings are taken in the morning and evening. Twice a day you take three measurements in a row with short breaks. While standing, keep the device parallel to the floor.

Inhale as deeply as possible, then tightly clasp the mouthpiece of the device with your lips and exhale sharply into it. Make sure that the device is clean and the pointer is at the zero mark before use. The best of the three indicators is recorded in a special chart.

Download peak flow graph

With proper control of bronchial asthma, the PEF indicator graph will look like a straight line, without sharp fluctuations. It should be remembered that the morning indicator, as a rule, will be less than the evening one.

If a “morning dip” is formed, that is, a significantly low morning PEF indicator, then this already indicates insufficient control of the disease. This way you will monitor your maximum expiratory flow, which is especially important for controlling bronchial asthma.

In the doctor's office, a peak flow meter is used to make a diagnosis. Using the device at home, you can not only determine the effectiveness of treatment and the degree of control of the disease, but also predict its exacerbation.

In accordance with peak flowmetry data and the patient’s condition, the doctor correlates his diagnosis with one of three zones: green, yellow or red, and draws up an individual plan for the management of bronchial asthma.

How to choose and where to buy a peak flow meter? You can buy a peak flow meter at a pharmacy or specialty store. The scale of the device should correspond to the value of your PSV.

Since the indicator is much lower in children, some companies have specially developed a children's peak flow meter with a reduced scale, which makes it possible to more effectively measure exhalation flow rates in childhood asthma. A peak flow meter for children is presented, for example, in the Personal Best line of devices.

A device with a reduced scale is suitable for a child under 10 years of age and up to 140 cm. It is recommended to replace the peak flow meter every year, however, some models - for example, the Omron PFM 20 peak flow meter - have a service life of two years.

Spacer

The spacer is the second extremely convenient auxiliary equipment for people suffering from bronchial asthma and chronic obstructive pulmonary disease. This device complements the design of metered dose aerosol inhalers, ensuring the correct dosage, safety and effectiveness of their use. Disadvantages of aerosol inhalers.

Attention!

Since during inhalation the aerosol medicine enters directly into the bronchi, the use of aerosol inhalers is recognized as the most effective method of treatment, especially for bronchial asthma and chronic obstructive bronchitis. In this regard, aerosol inhalers are very popular today. However, you still need to know how to use them.

According to statistics, only about 30% of patients use the inhaler correctly, observing the coordination of inhalation and pressing the canister. In addition, the speed of the drug jet when pressing the inhaler reaches 28 m/s. Relative to the speed of a person's inhalation, this is too fast, resulting in ineffective treatment.

There are a number of other consequences of using your inhaler incorrectly. The inhalation drug should have a local effect on the lower respiratory tract. However, large aerosol particles and particles that do not enter the bronchi due to insufficiently strong and deep inspiration settle in the larynx, pharynx, trachea, and then enter the stomach.

As a result, the drug affects not only the bronchi, but also the entire body (systemic effect). Noticeable complications can arise from improper use of hormonal aerosols: hoarseness, oral candidiasis, cough, etc.

Why do you need a spacer? The task of the spacer is to facilitate the process and increase the effectiveness of treatment with the inhaler. Coordination of pressing and inhalation does not play a significant role here. The spacer slows down the speed of movement of aerosol particles.

In addition, the particles come out of it in the size required for the most effective entry into the bronchi - from 2 to 5 microns. Using a spacer makes it easy to inhale for young children and adults anywhere and in any situation, even in the event of a severe attack.

Who is recommended to buy an inhaler spacer? It is difficult to overestimate the role of the spacer when the inhaler is used by children, patients who are forced to take hormonal medications, and those who are diagnosed for the first time.

How to choose and buy a spacer?

- spacer volume: larger volume spacers are most effective, but a small volume spacer is suitable as a travel option (for example, the Free-Breath line includes devices of various parameters) - spacer with a mask: using a mask reduces the effectiveness of treatment - it is recommended to buy a spacer with a mask if you are weakened or patients in serious condition, as well as children under 5 years of age (among Able’s products are masks for children under one year of age (No. 1) and over one year of age (No. 2)) - valve spacers are recommended for children, they increase the efficiency of inhalation and reduce aerosol loss and allow for inhalation in several breaths (a good option would be the Philips “Respironics OptiChamber Diamond” spacer) - the spacer and inhaler must be compatible - the spacer is used only for aerosol and is not suitable for drugs in the form of dry powder

How to inhale with a spacer?

- before installing the spacer, do not forget to remove the protective cap from the inhaler and from the spacer - shake the aerosol can after installing the spacer - during inhalation, the bottom of the can should be above the mouthpiece - when starting inhalation, first take a deep breath - then take a full, deep, but not inhale too quickly through the spacer - it is most effective to immediately inhale one dose in one spray - however, the aerosol is stored in the spacer for another 30 seconds, so the device allows inhalation in several breaths, which is convenient not only for children, but also for adults - hold your breath after inhalation for 6-8 seconds - inhalation of several doses is performed sequentially - repeat inhalation after 30 seconds

- after inhalation, rinse your mouth and wash your face if you used a mask

Source: http://www.doctor-al.ru/article/446/34146/

How does an inhaler help with asthma?

Nebulizers for asthma save a person’s life. This is a serious and often incurable disease. Occurs due to the influence of allergens on the respiratory organs. With the help of antihistamines and other drugs, good treatment results can be achieved. Inhalers help control the progression of the disease and prevent its exacerbation.

Types of inhalers and use for asthmatics

Such drugs have a great advantage because they deliver the drug to the site of irritation. Another attack can be triggered by: nervous tension, stress, cold air. Therefore, inhalers are very different, even pocket-sized. After all, people with asthma should always carry this device with them. It is worth noting that they are very convenient for children to use.

Types of inhalers:

• Powder - the product enters the body as a dry powder. This device is very convenient and easy to use. Among the disadvantages, one can note the high price.
• Spacers are small metal (sometimes plastic) chambers. They are attached to the inhaler. The principle of their action is that when you inhale, the drugs enter the lungs, and when you exhale, the inhaler valve closes. This allows you to save medicine and maximize its delivery to the site of irritation. It is recommended for use in the treatment of bronchial asthma in children. At different ages, they do not always understand how to breathe correctly when inhaling. In this case, this device is simply a godsend.
• Nebulizers are a modern type of inhaler. With their help, you can ensure maximum spraying of the medicine on a small area of ​​the bronchi. They are very effective and provide maximum impact of the medications. Among the shortcomings, it is worth noting the small size. Therefore, it is impossible to carry them with you, just as it is impossible to use them in case of an accidental attack of suffocation. They are suitable for treatment in a hospital or at home. Nebulizers are divided into compressor and ultrasonic. The latter, with the help of vibrations, distributes the substance even to remote parts of the respiratory tract. Therefore, when choosing which one is better, you should pay attention to the effectiveness of the treatment. Among the unusual nebulizers are pocket ones. They went on sale not long ago. They work thanks to batteries, but have a very high price. Therefore they are not so popular.
• Liquid aerosols - they can be used to use cans of different medications and doses. Their price is quite cheap. And they are also easy to use. But they have a significant drawback - drugs enter the respiratory organs only when inhaled. To use this asthma inhaler you must undergo training. It is important to consider that when using an aerosol, medications settle in the mouth, albeit in small quantities. But then they enter the digestive system and cause negative consequences. More often this happens from an overdose of the drug.
• Hormonal - designed for treatment with glucocorticosteroids. Among these inhalers are the well-known ones: Symbicort and Salbutamol. Such inhalers for bronchial asthma and not only relieve swelling and inflammation of the mucous membranes. This is influenced by the well-known hormone – adrenaline. It is worth noting that such inhalations do not cause side effects, since the steroids do not penetrate into the blood. They are prescribed after treatment with drugs for internal use. For asthmatics, these inhalers are among the best. They not only ensure that the medicine is inhaled, but also control the air that enters the lungs. Thus, the required amount of medicine is determined. All this is done by the inhaler, not by the person.

What inhalers are used for asthma?

Typically, inhalers contain one or the other medicine. They are designed for use in exacerbation of asthma and asthma attacks. They can be prescribed for long-term treatment of a disease, or for one or more applications. The contents of the inhaler can be changed and a canister with the necessary medications can be placed. Among them are often prescribed:

• Symbicort, Salbutamol;
• Becotide, Beclomethasone;
• Ingacort, Fluticasone.

It is worth noting that asthma inhalers can be used for inflammation and as a bronchodilator. Thus, they relieve an asthma attack and eliminate the causes of inflammation. For this purpose, the following drugs are used: Salbutamol, Terbutaline, Levalbuterol. You can relax the bronchi with medications such as Ipratropium and Atrovent.

A doctor should prescribe inhalations for asthma. At the same time, taking into account the peculiarities of allergies and the factors that contribute to its exacerbation. Each can of medicine must be carefully examined before use. One medicine in its content is intended to eliminate the specific cause of an attack or inflammation.

What medications are used in inhalers?

Despite the fact that in modern medicine there is a wide range of drugs, Salbutamol and Symbicort are most often used in inhalers. Such inhalations for bronchial asthma are given to adults and children. They are the most effective because they relieve symptoms of the disease in a short time. To avoid undesirable consequences, you must undergo training before use.

There are other medications that are prescribed for inhalation. They have the following names:

• Magnesium sulfate;
• Lazolvan;
• Dekasan;
• Atrovent;
• Berotek.

In addition to medications, inhalations with mineral water (Borjomi) and saline may be prescribed. They help treat bronchitis at the initial stage.

In what cases should inhalations not be done?

Contraindications for use:

• Hemorrhages in the lungs (blood is visible during expectoration);
• Pneumothorax;
• Diseases of the heart and vascular system;
• Disturbances in blood clotting and circulation;
• Acute stage of hypertension;
• The period after strokes and heart attacks;
• Hypersensitivity to certain drugs;
• Increase in body temperature more than 38°.

Some inhalers cannot be used if you have diabetes. This information is indicated in the instructions for use. Inhalers, including asthmatic ones, should not be used immediately after physical activity.

It is necessary to make a time interval of at least 2 hours. After inhalation, smoking is prohibited. Inhaling nicotine is also not recommended.

After such a procedure, it is better for the patient to be under the supervision of a specialist for at least 20 minutes.

How to use inhalers?

Before using the inhaler for asthma or other diseases, you should read the instructions for use. Then the treatment will be effective and the risk of side effects will decrease.

The following recommendations will help you use your inhaler correctly:

1. Before use, you need to clean your mouth from any remaining food (you can simply rinse);
2. Shake the can and remove the cap;
3. After exhaling deeply, squeeze the tip of the canister tightly with your lips;
4. It is important to consider that the medicine is delivered by inhaling and pressing the aerosol. This must be done simultaneously;
5. Then remove the tip and hold your breath (10-15 seconds);
6. The last stage of use will be exhalation. Then the can must be closed.

What should you pay attention to when choosing an inhaler?

This issue must be approached with all seriousness. After an examination and diagnosis, the doctor determines whether the patient needs inhalation or not. It is prohibited to use any type of inhaler yourself. But you can express your wishes to the doctor regarding the comfortable and convenient use of this device. The following information will help with this:

• The most convenient inhaler is a pocket one;
• The device should be simple and understandable to use so that you can use it independently during an attack;
• It is very convenient if the inhaler independently controls the dose of the medicine;
• Affordable price.

Inhalers for children

The name nebulizer became popular not so long ago. Previously, steam inhalations were used to treat children from various diseases. For a child, this process is a real challenge.

Modern inhalers make treatment as comfortable as possible. Children are recommended to use spacers. They independently distribute and control the medicine, regardless of how the child breathes.

Most children are afraid of such devices because they do not know how to breathe correctly.

Treatment with inhalers is prescribed by a doctor. This also applies to medications for such procedures and their dosage. There are different types of medications that are used to treat children. The most famous of them:

• Steroid drugs – Busedonide, Beclomethasone;
• Drugs that have a direct effect on the respiratory organs and can relieve asthma attacks;
• The best drugs are Salbutamol, Terbutaline.

Bronchial asthma occurs against the background of allergies and certain consequences. You cannot self-medicate children and put it off. This can cause serious complications.

Adults and children who suffer from asthma are advised to always carry inhalers with them. You can have several. For example: one is pocket-sized to always have nearby, and the other is for home use.

Nebulizers should be in every home, especially if there are children. They help quickly cure colds and various respiratory diseases.

Asthma is one of the most common chronic diseases, its prevalence among adults is about 5%. Among athletes, its prevalence is even higher - estimated at 10-20%.

An acute attack of asthma can be triggered by a variety of stimuli, including airborne dust, exposure to certain chemicals or animals, certain medications (such as nonsteroidal anti-inflammatory drugs), viral infections, and psychological stress. It is also well known that intense physical activity can cause asthma symptoms, defined as exercise asthma (EA). Inhalation of large volumes of cold, dry air, leading to bronchitis, may play a key role in the development of asthma in winter sports athletes.

Endurance athletes most often suffer from AFS. The high incidence of exercise asthma in swimmers may be due to inhalation of chlorine fumes, which is a known chemical irritant.

Inhaled β2-agonists, which are the drugs of choice for patients with asthma, are prohibited for use in athletes without asthma under the current WADA Prohibited List (the Prohibited List). This means that the diagnosis of asthma or AFS in an athlete must be confirmed by a medical commission, the diagnosis criteria must comply with national or international recommendations; and before starting to take ?2-agonists, it is necessary to formalize a therapeutic exception accordingly.

The main reason for the ban on the use of inhaled β2-agonists in athletes without asthma is their ability to increase performance. This article is devoted to the analysis of the scientific basis for this statement.

Diagnosis of asthma

The diagnosis of asthma can be suspected in the presence of typical respiratory/expiratory symptoms, but the diagnosis must be confirmed by additional instrumental studies. The causes of respiratory symptoms can vary. Often, the causes of shortness of breath or even suffocation during exercise in individuals may be the person's lack of training, which leads to an erroneous diagnosis of asthma.

Pulmonary function testing (pulmonary function, respiratory function) is absolutely necessary for a reliable diagnosis of asthma. In most cases, simply measuring FEP at rest with forced expiratory volume in 1 second (FEV-1) is sufficient. If FEV-1 is reduced or increased by at least 12% after inhalation of a beta2 agonist, the diagnosis of asthma can be considered confirmed. However, in most cases of AFS or bronchial hyperreactivity, a provocative test is necessary, which consists of measuring EF before and after exercise.

If this procedure does not help in diagnosing asthma, so-called athletes-specific tests may be an alternative. field tests. The test is considered positive if FEV-1 drops by 10 percent or more after exercise. Another method to assess pulmonary function is the methacholine test, which can cause bronchoconstriction. If asthma is suspected (recurrent seasonal complaints), allergy testing is necessary.

To document asthma, exercise asthma, or exercise-induced bronchoconstriction, the International Olympic Committee (IOC) recommends the following criteria:

Bronchodilator test - increase in FEV-1 by 12% or more after inhalation of a beta 1 agonist (compared to baseline value)
Provocative bronchial tests - eucapnic hyperventilation, exercise test in the laboratory or in the field, inhalation of a hypertonic aerosol, methacholine test.

A concentration of salbutamol in urine over 1000 ng/ml means a positive doping test due to the fact that such a high concentration cannot be associated with inhalation of the drug alone.

Treatment of asthma in athletes

There are no fundamental differences in the basic treatment of asthma in athletes and in the general population. According to current recommendations, the basis of asthma therapy should be anti-inflammatory drugs, preferably inhaled corticosteroids. Shortly before the start of exercise, inhalation of a short-acting α2-agonist may be useful in preventing an attack of exercise-induced asthma. Prophylactic use of short-acting inhaled α2-agonists may be sufficient for athletes with infrequent exercise-induced asthma attacks. For all other athletes, a combination of inhaled corticosteroids and long-acting β2-agonists is recommended. Overdose of inhaled β2-agonists may lead to side effects such as palpitations, tachycardia, tremor or extrasytoles.

Athletes with long-term asthma may also use medications containing leukotrienes and cromolyn (sodium cromoglycate and nedocromil) to relieve symptoms.

Both drugs have a beneficial effect on both bronchoconstriction and inflammatory reactions. The side effects of these drugs are not yet known.

However, Nedocromil, for unknown reasons, has not demonstrated success in elite hockey players with asthma-like symptoms. In general, sodium cromoglycate and nedocromil have been shown to be less effective than α-2 agonists.

Are 2-agonists capable of improving athletic performance?

This study analyzed 20 randomized, placebo-controlled trials designed to evaluate the effect of inhaled α2-agonists on physical performance in athletes without asthma. Athletes involved in sports such as cycling, middle and long distance running, cross-country skiing, triathlon, and weightlifting were included. In most of these studies, inhalation of α2-agonists was performed between 15 and 30 minutes before the start of exercise. Four of these studies administered high doses of salbutamol (800–1200 mg). In three studies involving skiers, the ambient temperature ranged from -10°C to -15°C, i.e. environmental conditions most likely to trigger physical exertion asthma. Fifteen studies examined salbutamol, 4 included salmeterol, 2 included formoterol, and one included terbutaline. Two studies compared α2-agonists (salbutamol/formoterol, selbutamol/salmoterol).

An increase in performance was demonstrated in only three studies, as evidenced by an increase in peak load power during the repeated Wingate test. However, these subjects were not professional athletes. A lower level of performance (compared to professionals) could be the cause of rapid fatigue during repeated testing, which was compensated by taking bronchodilators.

Taking 180 mg of salbutamol improved pedaling time in cyclists during a grueling final sprint. Representatives of recreational sports participated in this study. However, another study with a similar design did not confirm the results. It showed that inhalation of a high dose of salbutamol (800 mg) improved pedaling time by 2%. The greatest increase was observed in athletes with the worst initial indicators. In contrast, in two studies, running time after exhaustion was reduced by salbutamol and salmeterol. Even high doses of salbutamol did not improve performance in three of the four studies. Inhalation of α2-agonists did not affect the physical condition of athletes after hypothermia. Unlike inhaled α2-agonists, oral salbutamol may improve muscle strength and physical endurance. However, the dose required to achieve these effects is 10-20 times higher than the dose used by inhalation.

In general, according to studies conducted, inhalation of β2-agonists does not lead to an effect on physical performance in professional athletes without asthma. In addition, there is no evidence of an anabolic effect from inhaled α2-agonist. It is noteworthy that after inhalation of a beta-2 agonist, lung function increases according to most studies (usually an increase in vital capacity was assessed). It is clear that inhalation of a beta-2 agonist induces some increase in bronchodilation in healthy athletes. But this improvement in pulmonary function does not translate into improved performance in professional athletes, apparently due to the fact that reduced ventilation is generally not a limiting factor during exercise testing in young athletes without asthma.

Beta?2-agonists and anti-doping control

WADA has published an updated annual international Prohibited List of Substances and Methods. Currently, all α2-agonists are prohibited both in-competition and out-of-competition with the exception of formoterol, salbutamol, salmeterol or terbutaline when used by inhalation for the prevention or treatment of exercise asthma. Filling out the TI is necessary for treatment with beta?2 agonists. The completed TUE must be sent to the relevant national association or international association (for international level athletes). The TUE must be completed and signed by both the athlete and the athlete. Pulmonary function test results should also be presented in this document. A therapeutic exception is not submitted until approved by an independent medical review team. The time required to make a decision can be up to several weeks, however FIFA and UEFA have established the practice of providing temporary permission, and requesting a detailed clinical diagnosis later if required.

It is clear that there are serious administrative obstacles to the use of inhaled α2-agonists. For many athletes, confirming the presence of asthma through pulmonary function testing and provocative tests is not possible and requires specialized medical testing, which can be costly. Unlike corticosteroids, inhaled beta-22 agonists (or asthma inhalers) are prohibited not only during competition, but also during training, which can lead to more problems in the future.

Practical significance

Many athletes without asthma view inhaled β2-agonists as performance-enhancing agents, although scientific research clearly rejects such an effect. The use of these drugs to improve performance is erroneous. However, some other (approved) substances, such as acetylsalicylic acid or other analgesics (for example, diclofenac) with well-known side effects, are used much more often without indication. In this regard, it seems controversial to ban the use of a drug on the sole grounds that it is being used erroneously.

The prevalence of asthma in athletes is higher than in non-athletes, implying a higher frequency of use of α2-agonists.

The requirement to fill out a TUE obviously leads to an additional administrative burden on athletes, doctors and sports associations. This can harm athletes by interfering with drug treatment. It is very doubtful that such expenditures are really necessary and that they really help the fight against doping. It is necessary to conduct a campaign to educate athletes and coaches on the correct use of inhalers and explain their ineffectiveness in improving athletic performance.

In conclusion, it is worth noting that the inclusion of α2-agonists on the Prohibited List has led to renewed debate about their effects on performance. Obviously, substances and methods that have a proven effect on athletic performance and can identify unfair competition deserve much more attention: anabolic steroids, erythropoietin, human growth hormone, insulin-like growth hormone, blood doping or similar substances and methods.

The article was prepared and edited by: surgeon The description is valid on 16.01.2015

• Latin name: Salbutamol
• ATX code: R03AC02
• Active substance: Salbutamol
• Manufacturer: OJSC “Moskhimfarmpreparaty im. ON THE. Semashko”, CJSC “Binnopharm”, CJSC “Altaivitamins” (Russian Federation), TEVA (Israel)

Compound

One dose of metered dose inhalation aerosol contains 124 mg of salbutamol sulfate, which corresponds to 100 mcg of pure substance. Ethanol and hydrofluoroalkane are used as excipients.

One tablet may contain 2 or 4 mg of the active substance, prolonged-release tablets (retard) - 4 mg (for children) and 8 mg (for adults).

One dose of powder for inhalation contains 200 or 400 mcg of salbutamol, syrup for oral use - 0.4 mg/ml, solution for inhalation - 1.25 mg/ml (the solution is supplied to pharmacies in 2 ml ampoules, according to 20 ampoules in one package), in injection solution - 0.1 mg/ml.

Release form

Salbutamol (INN - Salbutamol) has the following dosage forms:

• metered-dose aerosol for inhalation 100 mg/dose (available in aluminum cans under pressure, 200 doses in each inhaler; when sprayed onto a glass surface, the contents of the can leaves a white spot);
• dosed powder for inhalation 200 or 400 mg/dose;
• film-coated tablets of 2 and 4 mg.

Salbutamol preparations sold under other brand names may also take the form:

• retard tablets;
• solution for inhalation;
• injection solution;
• syrup;
• concentrate for preparing an infusion solution;
• capsules filled with powder for inhalation use.

pharmachologic effect

Salbutamol is bronchodilator , a selective β2-adrenergic agonist (selective antagonist of β2-adrenergic receptors). Pharmacological action of the drug: tocolytic and bronchodilator.

Pharmacodynamics and pharmacokinetics

When used in a therapeutic dose, it has a pronounced bronchodilator effect , warns and stops bronchospastic syndrome , increases vital capacity of the lungs, makes it difficult to release into the extracellular space histamine , factors chemotaxis , a slowly reacting substance and a number of other highly active substances.

With the use of salbutamol, slight positive foreign and chronotropic effects on heart muscle .

The drug promotes expansion coronary arteries of the heart , suppression of early and late reactivity bronchi , reducing resistance in respiratory tract , as well as tone and contractile activity myometrium , function improvement ciliated bronchi , stimulates sputum discharge and mucus production.

At the same time, the drug has practically no effect on β1-adrenergic receptors, does not provoke a decrease and, in comparison with other drugs with a similar mechanism of action, has a much lesser effect on heart .

Salbutamol also has metabolic effects: it helps reduce the concentration of potassium in, affects the breakdown process glycogen before glucose (glycogenolysis) and secretion.

In some patients (especially in patients with) it is capable of providing hyperglycemic and lipolytic effects , thereby increasing the risk of developing lactic acidotic coma .

After administration of inhaled forms of the drug, the effect begins to develop after 5 minutes and reaches a maximum within 30-90 minutes (about 75% of the maximum effect is achieved within 5 minutes).

From 10 to 20% of the dose received by the patient ends up in respiratory tract , the remaining 80-90% remain in the device and settle in oropharynx , after which it is swallowed. The substance remaining in the respiratory tract is partially absorbed into lungs and, without being biotransformed into them, enters the bloodstream.

Part of what got into Gastrointestinal tract substances are absorbed and actively metabolized on first pass through liver with the formation of phenolic sulfate.

Both the conjugate and the unchanged substance are excreted primarily in the urine.

Most of salbutamol injected into a vein, taken orally or inhaled is eliminated from the body within 72 hours. The half-life is from 3.7 to 5 hours.

Indications for use

Indications for the use of Salbutamol are:

• observed in all forms bronchospasm (the product can be used both for cupping bronchospastic syndrome , and to prevent it);
• emphysema ;
• chronic ;
• asthmatic bronchitis ;
• uncomplicated premature birth.

In pediatrics, Salbutamol is also used to treat broncho-obstructive syndrome .

Contraindications

The use of Salbutamol is contraindicated in:

• increased sensitivity to the components of the drug;
• heart rhythm disturbances (for example, when polymorphic ventricular extrasystole or paroxysmal );
• heart defects ;
• myocarditis ;
• tachyarrhythmias ;
• aortic stenosis ;
• thyrotoxicosis ;
• decompensated ;
• epileptic seizures ;
• pyloroduodenal narrowing ;
• liver and/or kidney failure;

The drug is not prescribed in combination with non-selective β-blockers, or for the treatment of children under 2 years of age.

It should be used with caution when pheochromocytoma , severe form chronic heart failure , arterial hypertension .

Intravenous use of Salbutamol is contraindicated in:

• intrauterine fetal death;
• birth canal infections;
• bleeding associated with placenta previa;
• premature placental abruption;
• threatening spontaneous in the 1st or 2nd trimester of pregnancy;
• late (toxicosis of the 3rd trimester of pregnancy).

Side effects

Salbutamol, produced in the form of an aerosol, does not cause side effects when used in therapeutic doses.

Oral use, subject to the dosage regimen described in the instructions, is rarely accompanied by unwanted side effects.

When a single or daily dose of Salbutamol is exceeded, as well as in patients with hypersensitivity to β2-adrenergic receptor stimulants, the most significant side effects may be fingers or hands, internal tremors, and increased tension.

If the therapeutic dose is significantly exceeded or the patient is particularly sensitive, transient dilatation of peripheral vessels, moderate tachycardia, nausea, muscle cramps, and vomiting may occur.

Extremely rare, manifesting as a skin rash, collapse , hypotension , bronchospasm .

Instructions for use of Salbutamol

For patients over 12 years of age, the daily dose of Salbutamol in dosage forms intended for oral administration ranges from 6 to 16 mg. It is recommended to divide it into 3-4 doses. In cases where this is necessary, the daily dose may be increased to 32 mg with a frequency of applications 4 times a day.

For children from 6 to 12 years old, Salbutamol 2 mg 3 or 4 times a day is indicated; for patients from 2 to 6 years old, the optimal dose is 1-2 mg with a frequency of applications 3 times a day.

When administered by inhalation, the dose depends on the prescribed dosage form. In accordance with the instructions for use, Salbutamol aerosol is prescribed for relief bronchospastic syndrome or attack of bronchial asthma . For adults, the spray is usually recommended to be administered at 0.1-0.2 mg, for children - at 0.1 mg.

The frequency of procedures depends on the clinical situation and indications.

In order to prevent stress-related attack of bronchial asthma Before physical activity, Salbutamol aerosol is administered to children in a dose of 0.1 mg, to adults - 0.2 mg. The highest daily dose is 0.8 mg (corresponds to 8 inhalations).

The medicine, available in powder form, should be used according to a similar scheme, but with a corresponding doubling of the dose.

The solution for inhalation is used in a dose of 2.5 mg 3 or 4 times a day. If appropriate, it is possible to increase the dose to 5 mg with the same frequency of applications.

Instructions for use of the Salbutamol inhaler

Before using the inhaler, you should check its functionality. This procedure is also recommended if the patient has not used it for some time.

• It is necessary to remove the cap from the inhaler and make sure that the outlet tube is not clogged with dust or dirt.
• While holding the can in a vertical position, place your thumb under the bottom and your index finger on its top, after which you need to vigorously shake the can up and down several times.
• After taking a deep breath (it is recommended to inhale without straining), you should throw your head up and tightly pinch the outlet tube of the inhaler with your lips.
• Holding the tube with your lips, you should take a slow, deep breath, while simultaneously pressing your index finger (in the first third of your inhalation) on the valve of the inhaler can and releasing a dose of medication. The air continues to be inhaled slowly.
• Having removed the canister tube from your mouth, you need to hold your breath for 10 seconds (or as long as possible without straining), and then slowly exhale through your nose.
• If you need to take more than one dose of Salbutamol, wait for about a minute after the first inhalation and then repeat all the steps described above (starting from the second point). After completing the procedure, the can should be closed with a cap.

When releasing a dose of medicine, you should not rush; to achieve maximum effect, you need to inhale the air as slowly as possible. It is optimal to practice a little in front of a mirror before the procedure.

If during inhalation steam comes out from the top of the inhaler or from the corners of the mouth, you must start inhalation again from the second point.

How to clean the inhaler?

The inhaler must be cleaned at least once a week. The can is removed from the plastic case, after which the case and cap are washed with warm water (not hot!).

Washed parts should be dried thoroughly without using heating devices. After this, the can is again placed in the case and closed with a cap.

Do not dip the metal can into water.

Overdose

Symptoms of an overdose of Salbutamol are:

• dilatation of peripheral vessels;
• nausea and vomiting;
• increased excitability;
• ventricular flutter;
• decline in performance blood pressure ;
• muscular tremor ;
• hypokalemia ;
• hypoxemia ;
• headache ;
• general malaise;
• hyperglycemia replacing hypoglycemia .

Treatment involves discontinuation of the drug, prescribing the patient cardioselective β-blockers and symptomatic therapy.

If there is a suspicion of an overdose of Salbutamol, it is necessary to keep serum potassium concentrations under constant monitoring.

Interaction

When using Salbutamol in combination with non-cardioselective β-blockers, mutual inhibition of therapeutic effects is possible. In combination with may increase the risk of developing and tachycardia (in particular, supraventricular extrasystole ).

In combination with diuretics , glucocorticosteroid drugs And xanthine derivatives the risk of developing hypokalemia .

Terms of sale

A prescription is required to purchase the drug.

Salbutamol recipe in Latin:
Rp: Aeros. Salbutamoli 12ml
D.t.d:
S: During an attack of suffocation, take 1-2 breaths

Storage conditions

The aerosol can must be protected from impacts and falls.

Best before date

36 months from date of issue.

special instructions

Increasing the dose or increasing the frequency of applications should be under the supervision of a physician. Reducing the interval is allowed only in extreme cases, and it must be strictly justified.

When using the product, there is a risk of developing hypokalemia , therefore, in patients with severe forms bronchial asthma It is recommended to constantly monitor serum potassium concentrations. Risk hypokalemia increases with hypoxia.

The World Anti-Doping Agency (WADA) prohibits the use of Salbutamol in sports, since this drug has the ability to artificially increase endurance and physical activity during sports competitions.

The use of tablet forms of the drug is usually recommended when inhalation administration of the drug is impossible (for example, in small children), since exceeding the dosage in this dosage form can provoke cardiac stimulating effect .

Salbutamol analogs

Level 4 ATX code matches:

Structural analogues of Salbutamol are drugs Ventacol , Salgim , , Salbutabs , Salbumol , Salbupart , Salamol (Salbutamol-Teva), Bronchovaleas , Ecovent , Proventil , Albuterol , Aerolyn , Volmax , Ventilan , Aloprol .

A similar mechanism of action characterizes drugs Athymos , Oxis Turbuhaler , Serevent , Formoterol , Infortispir Respimat , Striverdi Respimat .

Which is better - Salbutamol or Ventolin?

Ventolin is a generic (or structural analogue) of Salbutamol. The drugs contain the same active ingredient, so they have the same indications and contraindications and are interchangeable.

Some patients have the question “ Ventolin (Salbutamol) - hormonal or not? Experts answer that the drug does not belong to the group of hormonal drugs and is bronchodilator to relieve bronchospasm .

These types of drugs are chemical derivatives (adrenaline ).

Where did Salbutamol Semashko go?

At special thematic forums in recent months, the question of where the Moscow salbutamol from the manufacturer Semashko disappeared has been actively discussed. In this regard, on the official website of Moskhimfarmpreparaty OJSC, an explanation from the management appeared as to why the drug produced by the company disappeared and where it went.

The thing is that this product contains chlorofluorocarbons, which pose a danger to the ozone layer. Therefore, in accordance with the Montreal Protocol on Substances that Deplete the Ozone Layer, the Russian Federation had to decide to stop its release.

Salbutamol Semashko was discontinued, which was announced at a conference on regulating the circulation of substances that deplete the ozone layer, which was held in Moscow in mid-August 2014, initiated and organized by the UN.

The management asks everyone interested in the question of where Salbutamol-Moskhimfarmpreparaty disappeared to wait out the current situation. By 2015, the company plans to release a new drug called “Salbutamol sulfate”, in which the prohibited components will be replaced with harmless ones.

In particular, the freon-11 solvent and freon-12 atomizer will be replaced with hydrofluorocarbon 134a, and it is planned to use alcohol as a solvent.

Salbutamol during pregnancy

During pregnancy, the use of Salbutamol is contraindicated. During the period, the drug can be prescribed if the benefit to the mother outweighs any possible risks to the child. This is due to its ability to pass into breast milk.

Reviews about Salbutamol

Salbutamol is described as a strong and effective remedy. In particular, a lot of positive reviews were left about drugs produced by Russian companies Moskhimfarmpreparaty im. ON THE. Semashko and Altaivitamins.

For many people who suffer from bronchial asthma , these remedies are a real salvation, since they quickly improve the patient’s condition even with severe bronchospasm .

Another advantage of domestic drugs is their low price compared to foreign analogues, which is a very important selection criterion for a person who is forced to use the drug for a long time.

Reviews for Salbutamol-Teva look somewhat less optimistic. Almost all patients who have tried this drug note the aesthetic appearance and inconvenience of the inhaler. The main disadvantage of the device is the short mouthpiece, which makes using the medicine not very comfortable.

Salbutamol price

The price of Salbutamol aerosol depends on which company produced the drug and varies from 95 to 220 rubles. In Ukraine, the average price of a Salbutamol inhaler is 35 UAH.

Noting the high effectiveness of the drug from Moskhimfarmpreparaty OJSC and the fact that the drug has disappeared from pharmacies, many people with bronchial asthma are wondering where to buy Salbutamol Semashko in Moscow. Pharmacy staff advise looking for medicine on special forums and online pharmacies.

Sharing personal experience, many people say that you can try to buy Salbutamol Moscow in the regions. For example, one of the users wrote that he could not find the medicine in pharmacies in Moscow, but in one of the pharmacies in the suburbs it was sold in sufficient quantities.

• Online pharmacies in Russia Russia
• Online pharmacies in Ukraine Ukraine
• Online pharmacies in Kazakhstan Kazakhstan

ZdravCity

Salbutamol aerosol. d/inhal. doses 0.1 mg/dose 200 doses 12 ml n1 JSC Binnopharm

Salbutamol-teva aerosol. d/inhal. doses 100mcg/dose 200doses n1Norton Waterford/Ivax Pharmaceuticals

In 1 tablet salbutamol hemisuccinate 7.23 mg.

Sodium chloride, sodium carboxymethylcellulose; , cellulose acetate, magnesium stearate - as excipients.

Release form

Extended-release coated tablets 7.23 mg.

pharmachologic effect

Bronchodilator. Beta 2-adrenergic receptor stimulator.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Salbutamol - a selective stimulator of ß2-adrenergic receptors of bronchial smooth muscle, has a slight effect on ß1-adrenergic receptors of the myocardium. Relaxes the muscles of the bronchi and has a bronchodilator effect, prevents the development of bronchospasm, reduces resistance in the bronchi, restores breathing, and increases the vital capacity of the lungs.

It also causes dilation of the blood vessels of the heart. Has metabolic effects: affects glycogenolysis, has lipolytic and hyperglycemic effects, therefore increasing the risk of developing acidosis . Reduces content potassium in plasma. Has a longer lasting effect than salbutamol .

Pharmacokinetics

Well absorbed from the gastrointestinal tract. The prolonged form, due to the gradual release of the active substance, allows for therapeutic concentration in the blood and long-term maintenance. Excreted by the kidneys. The half-life is 6 hours. The effect of the drug lasts 12–14 hours.

Indications for use

Saltos is used for:

• emphysema ;
• chronic obstructive pulmonary disease ;
• to prevent asthma attacks at night.

Contraindications

• heavy heart failure ;
• heart rhythm disturbances ( ventricular extrasystole , paroxysmal tachycardia );
• cardiac ischemia ;
• myocarditis , heart defects;
• decompensated ;
• impaired renal and liver function;
• pyloroduodenal narrowing ;
• pregnancy;
• epileptic seizures ;
• age up to 6 years;
• increased sensitivity.

Use with caution when thyrotoxicosis .

Side effects

Saltos can cause hand tremors , headache, nervous tension, .

Less commonly noted: , nausea, vomiting, cramps, sweating.

Very rarely - urticaria, rash, erythema multiforme , , hypokalemia , aggressiveness, hallucinations, schizophrenia-like disorders , suicide attempts and urinary retention.

Instructions for use of Saltos (Method and dosage)

Taken orally, without chewing, 1 tablet once a day. To prevent asthma attacks at night, take 1 tablet 3 hours before bedtime. The dose, if necessary, is increased to 2-3 tablets per day - in the morning, the next two doses after 8 hours. Reducing the interval between doses is allowed in exceptional cases and is strictly justified. Taking high doses during an exacerbation bronchial asthma causes “rebound” syndrome - the next attack becomes more intense. In such cases, the treatment plan is revised. Do not use damaged tablets!

Saltos has proven itself in bodybuilding as a fat burner. Athletes take it as a means of losing weight and drying out adipose tissue. They believe that this drug is superior to other fat-burning sports analogues in its ability to burn fat.

The effect of the drug is realized by increasing body temperature by 10, after which it is maintained by burning fat during training. Stimulating production adrenaline And thyroid hormones also affects metabolism, particularly fat. The drug increases basal metabolism by 20-30%.

Athletes take the drug on training days at the rate of 7.23 mg per 25 kg of weight, for no more than a month, followed by a break of 1.5 months. The daily dose is divided into 3 doses with a 6-hour break, taking into account the half-life of the drug. Reducing the intervals between doses threatens the development of adverse reactions.

The use of Saltos in bodybuilding for weight loss is not approved by official medicine, since it is a drug intended to treat broncho-obstructive syndrome , and the instructions do not provide for its use for this purpose.

Before you start such a dangerous method of “burning fat” and start taking Saltos for weight loss, think about your health. Firstly, it is a chemical, and like all chemicals it has an adverse effect on the liver. Moreover, to achieve fat burning effect you need a much larger dose (up to 5-6 tablets per day) than for treatment bronchopulmonary pathology . Already when the dose is increased to 3 tablets per day, hand tremors And tachycardia !

The drug has medical contraindications and adverse reactions. Before use, you need to undergo an examination to exclude pathologies of the liver, kidneys and heart. It enhances excretion potassium from the body, and if diuretics are also used, then potassium deficiency occurs, manifested by convulsions, heart rhythm disturbances, and loss of consciousness.

Considering the other side effects that get worse with heavy physical activity, is it worth risking your health to lose a few pounds?

Overdose

Overdose is manifested by symptoms: angina pectoris , tachycardia , , headache, dizziness, dry mouth, insomnia, nausea, tremor, nervous tension, convulsions.

Treatment: symptomatic, begin with gastric lavage, with tachyarrhythmias beta-blockers are prescribed.

Interaction

Salbutamol enhances the effect of drugs that stimulate the central nervous system, causing the likelihood of extrasystoles while taking cardiac glycosides .

Simultaneous use xanthines entails development tachyarrhythmias , and anesthetic agents and — the appearance of ventricular arrhythmias.

The increase in heart rate and blood pressure caused by taking salbutamol makes it necessary to adjust the dose antianginal And antihypertensive drugs . Tricyclic antidepressants and MAO inhibitors used simultaneously with this drug lead to a significant decrease in blood pressure.

Diuretics And corticosteroids strengthen hypokalemia caused by salbutamol.

Simultaneous administration of drugs anticholinergic action helps increase intraocular pressure.

Incompatible with non-selective beta blockers .

Terms of sale

On prescription.

Storage conditions

At a temperature not exceeding 25°C.

Best before date

Analogues

Level 4 ATX code matches:

Salgim , Sterineb , Salamol , Cibutol , Cyclocaps , Salmo , Salbutabs , Salben , Bronchovaleas , Ventokol , Salbuvent , Ventodisk .