Instruction for use: Ipratropium bromide + Fenoterol (Ipratropii bromidum + Phenoterolum)

Pharmacotherapeutic group:

Beta-adrenergic agonist in combination

Pharmacological action.

Combined preparation with marked bronchodilator effect due to the action of members of the fenoterol and ipratropium bromide. Fenoterol exerts a bronchodilator effect, selectively exciting beta2-adrenergic receptors of the bronchi. Ipratropium bromide eliminates m-holinostimuliruyuschie effect on the smooth muscles of the bronchi and reduces the overproduction of sputum, has no negative effect on mucociliary clearance and gas exchange.

This combination enhances efficacy bronchodilator therapy of diseases accompanied by increased muscle tone and bronchial hypersecretion of mucus, and also allows the use of drugs at lower doses than monotherapy. After inhalation of the drug therapeutic effect observed after 15 minutes, reaching a maximum after 1-2 hours and lasts for up to 6 hours.

Indications.

COPD, asthma (treatment and prevention of acute attacks of breathlessness). Preparation of respiratory tract for aerosol administration of drugs (antibiotics, mucolytic drugs, corticosteroids, and others.).

Contraindications.

Hypersensitivity (including to atropine and its compounds), tachyarrhythmia, GOKMP, pregnancy (I trimester), children's age (up to 6 years).

Precautions

Coronary insufficiency, hypertension, diabetes mellitus (insufficiently controlled), recent myocardial infarction, severe organic heart disease and blood vessels, hyperthyroidism, pheochromocytoma, prostatic hyperplasia, bladder neck obstruction, angle-closure glaucoma, cystic fibrosis, childhood.

Dosing.

Inhalation. Aerosol for inhalations: adults and children older than 6 years - usually 1-2 aerosol dose 3 times a day. With the threat of respiratory failure - 2 dose aerosol, if necessary - after 5 minutes another 2 doses the next inhalation is performed not earlier than 2 hours.

The solution for inhalations: adults and children over 12 years of cupping - 1 ml (20 drops) solution, in severe cases, the dose may be increased to 2.5-4 mL (50-80 cap). Long-term intermittent therapy - 1-2 ml (20-40 cap) up to 4 times a day. In the case of moderate bronchospasm or the need for an auxiliary (artificial) ventilation recommended a lower dose - 0.5 ml (10-cap).

Children 6-12 years: mild asthma - 0.5-1 mL (10-20 cap), in severe cases, the dose may be increased to 3 mL (60 cap). Long-term and intermittent treatment: 0.5-1 mL (10-20 cap) to 4 times per day. In the case of moderate bronchospasm or need auxiliary (artificial) ventilation recommended a lower dose - 0.5 ml (10-cap).

Children aged 6 (body weight 22 kg) is determined from dose rate of 25 mg of ipratropium bromide and fenoterol 50 mg per 1 kg of body weight, respectively, and 0.5 ml (10-cap) 3 times a day.

The recommended dose is diluted immediately before use in a 0.9% solution of NaCl (not diluted in distilled water!) To a total volume 3-4 ml and inhaled nebulized for 6-7 minutes until the solution is completely consumed. The dose may depend on the mode and Performance inhalation nebulizer. The duration of inhalation can be controlled by the amount of the diluted solution. If necessary, multiple inhalations interval between them should be at least 4 hours.

Side effect.

Angioedema, paradoxical bronchospasm, skin rash, cough, dry mouth, change in taste, nausea, dizziness, nervousness, tremor of fingers, tachycardia, tachyarrhythmia; when the eye contact - mydriasis, paralysis of accommodation, conjunctival hyperemia, increased intraocular pressure (pain in the eyeball, blurred vision, feeling ghosting or color spots before his eyes).

Overdose.

Symptoms: tremor fingers, palpitations, tachycardia, feeling of heaviness in the chest, arrythmia, increased bronchial obstruction.

Treatment: the appointment of anxiolytic drugs (tranquilizers), selective beta1-blockers.

Interaction.

Concomitant use with xanthine derivatives, glucocorticosteroids and kromoglitsievoy acid enhances the effect with beta-blockers - weakens.

Xanthine derivatives, corticosteroids and diuretics enhance hypokalemia. Halogenated hydrocarbon drugs for general anesthesia (halothane, trichlorethylene, enflurane) increase the risk of side effects from the CCC.

MAO inhibitors, tricyclic antidepressants increase the effect of beta-adrenostimuliruyuschee.

Special instructions.

Shortly before the birth intake should be discontinued because of the possibility of weakening labor fenoterol.

You should avoid contact with the drug in the eye. In patients with a history of cystic fibrosis, possible violations of GI motility.

Solution for inhalation can be used by various units inhaled. In the presence of a stationary central oxygen supply, the best solution is administered at a rate of 6-8 l / min.