Atrovent
Atrovent (Ipratropium)Pharmacological action
Broncholitic preparation. Blocks m-holinoretceptors smooth muscles of bronchuses (mainly at level of large and average bronchuses). Having structural similarity to Acetylcholinum molecule, is its competitive antagonist.
Warns a bronchospasm resulting inhalation of a cigarette smoke, cold air, action of various preparations, and also eliminates a bronchospasm bound to influence of a vagus nerve.
At patients with a bronchospasm bound with a chronic bronchitis and an emphysema of lungs, appreciable improvement of function of lungs (augmentation of volume of the forced exhalation for 1 sec/OFV1/and average volume rate of the forced exhalation were enlarged by 15 % and more) becomes perceptible through 15 mines, the maximum effect is reached through 1-2 h and proceeds at the majority of patients to 6 h after introduction Bromidum.
At 40 % of patients with a bronchial asthma appreciable improvement of indicators of external breath becomes perceptible.
Atrovent (Ipratropium) does not render negative influence on slime secretion in respiratory tracts.
Indications
- Chronic obstructive illness of lungs (including a chronic obstructive bronchitis, an emphysema of lungs);
- A bronchial asthma easy and moderate severity level (especially with accompanying diseases of cardiovascular system).
Dosage regimen
To adults and children is more senior 6 years prescribe on 2 inhalation doses 4 times/days
The requirement for dose augmentation can testify to necessity of revision of the basic treatment. The general daily dose makes no more than 12 inhalations.
Rules of use of a preparation
Before use dosed out an aerosol for the first time it is necessary to press twice the valve before formation of a cloud of an aerosol.
Each time at use dosed out an aerosol it is necessary to observe following rules.
1. To take out a protective cap.
2. To make a slow, deep exhalation.
3. Keeping a cylinder to clasp labiums a handpiece. The cylinder should be referred in the bottom upwards.
4. Making as much as possible deep inspiration, simultaneously quickly to press a bottom of a cylinder before remission of 1st inhalation dose. For some seconds to hold the breath, then to take out a handpiece from a mouth and slowly to exhale. To repeat actions for reception of 2nd inhalation dose.
5. To put on a protective cap.
6. If the aerosolic cylinder was not used more than 3 days, before application it is necessary to press unitary the valve before occurrence of a cloud of an aerosol.
The cylinder is calculated on 200 inhalations. Then it is necessary to replace a cylinder. In spite of the fact that in a cylinder there can be some contents, quantity of the medicinal substance liberated at inhalation, decreases.
The cylinder is opaque, therefore the quantity of a preparation in a cylinder can be defined as follows: having taken out a protective cap, a cylinder immerse in the capacity filled with water. Quantity of a preparation define depending on a cylinder position in water.
The handpiece should be kept clean, in need of it it is possible to wash out in warm water. After use of soap or a washing-up liquid the handpiece should be washed out carefully water.
The plastic handpiece is developed for a mouth specially for dosed out Atrovent (Ipratropium) aerosol and serves for exact dosage of a preparation. The handpiece should not be used with other dosed out aerosols. It is impossible to use also dosed out aerosol Atrovent with other handpieces.
Side effect
The most frequent undesirable phenomena: a headache, a nausea, dryness in a mouth, rising of viscosity of a sputum.
The effects bound to anticholinergic action of a preparation: a supraventricular tachycardia, palpitation, accommodation disturbance, motility disturbance GASTROINTESTINAL TRACT, an ischuria (owing to low system absorption of a preparation are observed seldom and have reversible character). At patients with an obstructive lesion of urinary ways the risk of development of an ischuria raises.
From respiratory system: tussis is possible; seldom - a paradoxical bronchospasm.
From a sight organ: on occasion at hit in aerosol eyes the mydriasis, ophthalmotonus rising (especially at patients with an angle-closure glaucoma), an angle-closure glaucoma, a pain in an eye are observed.
Pain in an eye or the sensation of discomfort, indistinct sight, occurrence of an aura and colour maculae before eyes in a combination to a conjunctival and corneal hyperemia can be symptoms of an attack of an angle-closure glaucoma.
Allergic reactions: the dermal eruption, a Quincke's disease of tongue, labiums, persons, an urticaria, a stomatopharynx edema, an anaphylaxis, a laryngospasm, a bronchospasm.
Contraindications
- Pregnancy (I trimester);
- A hypersensibility to atropine and its derivatives;
- A hypersensibility to Atrovent (Ipratropium) and other components of a preparation.
With care it is necessary to prescribe a preparation at an angle-closure glaucoma, obstruction of urinary ways (including prostate hyperplasias), children's age till 6 years.
Pregnancy and lactemia
Safety of Atrovent (Ipratropium) application at pregnancy at the person is not established.
Atrovent (Ipratropium) application in I trimester of pregnancy is contraindicative.
Preparation appointment in II and III trimesters of pregnancy is possible only in the event that the prospective advantage of therapy for mother exceeds possible risk for a foetus.
However it is necessary to prescribe with care a preparation in thoracal feeding.
Special indicatings
It is not recommended to prescribe a preparation for emergency cupping of an attack of a bronchial asthma.
At patients with a mucoviscidosis the risk of development of disturbances of a motility GASTROINTESTINAL TRACT is raised.
The patients using dosed out Atrovent (Ipratropium) aerosol for the first time, should be warned, that the preparation has some other smack in comparison with the previous medicinal form containing freon. Patients should know, that both medicinal forms dosed out an aerosol completely are interchangeable and identical on the properties and efficiency.
The patient should be informed from volume, that if inhalations are insufficiently effective or there was an aggravation of symptoms it is necessary to address to the doctor for treatment planning change. In case of sudden occurrence and fast advance of a dyspnea the patient also should address immediately to the doctor.
In case of occurrence of any symptom of an attack of an angle-closure glaucoma it is necessary to prescribe the drops causing narrowing of a pupil, and immediately to address to the ophthalmologist.
Overdosage
Symptoms: specific symptoms of an overdosage it is not taped. Considering width of therapeutic action and a local way of Atrovent (Ipratropium) application, occurrence of any serious anticholinergic symptoms is improbable. Insignificant implications of system anticholinergic action (including dryness in a mouth, accommodation disturbances, CARDIAC CONTRACTIONS RATE rising) are possible.
Treatment: carrying out of symptomatic therapy.
Conditions and periods of storage
The preparation should be stored in protected from light, a place inaccessible to children at temperature not above 25 C. The Period of validity - 3 years.
The cylinder is under pressure. The cylinder cannot be opened and heated up to temperature above 50 C.
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