Index
It is used as an inhaler or nebulizer. The start of the action is typically 15 to 30 minutes and lasts three to five hours.
Berodual is a medicine that contains two active substances / active ingredients (salts): ipratropium bromide (belongs to the group M-holinoblokatorov) and fenoterol hydrobromide (belongs to the group of adrenomiméticos β-2).
Fenoterol: fenoterol hydrobromide has a selective stimulant effect on β-2 adrenergic receptors and relaxes the smooth muscles of the bronchi, counteracting the development of spasms.
Fenoterol blocks the release of inflammatory mediators and allergies of mast cells. With the introduction of fenoterol in higher doses, mucociliary clearance increases.
It is a short-acting β2-adrenoreceptor agonist designed to open the airways to the lungs. It is classified as a sympathomimetic β2 agonist and medication for asthma.
Fenoterol also stimulates β1 receptors in doses higher than the recommended therapeutic doses. Fenoterol also has a stimulatory effect on β-2 adrenoceptors in the heart and blood vessels, resulting in increased heart rate and strength.
It is believed that the association of increased risk of death was because, in general, it was used in massive doses for severe acute asthma attacks in the absence of medical assistance.
Excessive prescribed doses and excessive self-medication of the patient with β-agonists in acute asthma who do not respond to the usual doses are now generally recognized as undesirable with all β-agonist asthma inhalers.
Ipratropium, sold under the brand name Atrovent, is a drug that opens the middle and large airways in the lungs. It is used to treat chronic obstructive pulmonary disease and asthma symptoms.
Ipratropium bromide has anticholinergic properties. It diminishes the reflexes caused by the vagus nerve when counteracting acetylcholine (a mediator released from the ends of the vagus nerve).
The effect of Ipratropium on administration by inhalation is due to local anticholinergic effects rather than systemic. With the administration by inhalation of the substance in patients with bronchospasm, a marked improvement in lung function is observed within 15 minutes.
The maximum therapeutic effect is achieved 1-2 hours after inhalation and lasts up to 6 hours. Ipratropium bromide does not hurt mucociliary clearance, mucus production in the respiratory tract, and gas exchange processes.
Potentially serious side effects include urinary retention, worsening of airway spasms, and a severe allergic reaction. Ipratropium is a muscarinic antagonist, an anticholinergic that acts by relaxing smooth muscles.
Ipratropium was developed in Germany in 1976. It was approved for medical use in the United States in 1986. It is on the List of Essential Medicines of the World Health Organization, the most effective and safe medicines needed in a health system. Ipratropium is available as a generic medicine.
The mechanisms of action of fenoterol and Ipratropium are different. The active ingredients complement each other, which increases the spasmolytic effect on the musculature of the bronchi and achieves a pronounced therapeutic effect in various bronchopulmonary diseases with obstruction.
Uses of Berodual
The Berodual, a combined bronchodilator, is used for chronic obstructive pulmonary disease, asthma, nasal cavity obstruction, mucous membrane inflammation, and other conditions.
The Berodual contains Fenoterol Hbr and Ipratropium Bromide as active ingredients. The Berodual inhaler works by opening air passages to the lungs; opening the airways to the lungs by decreasing bronchoconstriction.
The Berodual is used to:
- Chronic obstructive pulmonary diseases.
- Asthma.
- Blocking of the nasal cavity.
- Inflammation of the mucous membrane.
It is used to treat or prevent bronchospasm (narrowing of the airways leading to the lungs) in asthma and chronic obstructive pulmonary disease.
Precautions
It should be avoided in patients allergic to any of the active substances (ipratropium bromide and fenoterol). If you have symptoms of an allergy, such as:
- Swelling or protrusion of the face.
- Swelling or protrusion of the tongue.
- Problems or difficulty breathing.
Stop use and call an emergency doctor or your treating doctor.
This medication should be avoided in patients with rapid heart rate ( tachycardia ) or obstructive hypertrophic cardiomyopathy (hereditary heart muscle disease). Tell your doctor if you have any heart disease before using this medicine.
The Berodual should be used only with additional precautions in the following conditions:
- Pheochromocytoma (tumor of the adrenal gland).
- Hyperthyroidism (overactive thyroid gland).
- In patients who have had a heart attack.
- Diabetes.
Patients who have low potassium levels or take medications that can cause potassium loss. Low potassium levels can cause serious arrhythmias (irregular heartbeats).
Be careful to avoid Berodual dew in your eyes, as it can cause eye damage.
It should be used only if necessary. Avoid frequent use, as it can signify that the disease is more difficult to control.
Athletes should know that this medication can affect the doping test results.
Side effects
The Berodual is generally well tolerated. It is possible to develop undesirable side effects from different systems in some situations.
On the part of the respiratory system:
- To.
- Irritation of the mucosa of the respiratory tract.
- Development of paradoxical bronchospasm (rarely).
On the side of the nervous system:
- Headache.
- Dizziness
- Change in taste and dry mouth.
- Nervousness.
- Tremors
Of the cardiovascular system:
- Incrise of cardiac frecuency.
- Tachycardia.
- Increased systolic and diastolic pressure decreased.
- Arrhythmia.
From the digestive system:
- Digestive disorders (nausea, vomiting).
- Violation of intestinal motility (mainly in patients with cystic fibrosis).
From other systems:
- Hypopotasemia.
- Increased sweating
- Weakness.
- Myalgia (muscle pain) and muscle cramps.
- Disturbance of visual accommodation.
- Retention of urination.
Allergic reactions:
- Eruption.
- Urticaria.
- Angioedema.
When the solution enters the eye, the pupil dilates. The intraocular pressure increases, accompanied by pain or discomfort in the eyeball, an unclear vision of the objects, the appearance of colored spots in front of the eyes, and redness in the conjunctiva.
The appearance of overdose symptoms is usually due to the action of fenoterol and excessive stimulation of β-adrenergic receptors.
It is possible to reduce or increase blood pressure (depending on the predisposition of the body), raise the difference between the upper and lower pressure, increase heart rate and tachycardia, tremor of the fingers, extrasystole, angina, arrhythmia, blood flow to the face and upper body, increased bronchial obstruction.
Signs of an overdose of ipratropium bromide: a violation of visual accommodation and dry mouth are generally poorly expressed.
The treatment for Beroduala overdose is symptomatic, including the use of tranquilizers and sedatives. In severe poisoning, intensive care is provided. As a specific antidote, beta-adrenergic receptor blockers (preferably β-1 blockers) are used.
However, in patients with chronic obstructive pulmonary disease and bronchial asthma, these medications can cause an increase in bronchial obstruction, so doses of an antidote should be selected with great care and care.
Use during pregnancy and lactation.
The Berodual can be used during pregnancy only if the benefit to the mother outweighs the risk to the child.
This medicine passes into breast milk, so you should avoid breastfeeding while using the Berodual medicine.
Recommended dose
Berodual dosage forms include aerosol and solution. The solution must be used through appropriate inhalers. Do not swallow the Berodual solution!
This medicine should be mixed with saline (0.9% NaCl) to a volume of 4ml. The solution thus prepared should be inhaled until all the liquid has been emptied.
The drug doses are selected individually, taking into account the indications and the patient’s age.
For adults (including the elderly) and children over 12 years old:
To relieve an acute attack of bronchial asthma, the usual dose of Berodual solution is 20 drops (1ml) with mild and moderate attacks.
In complex cases – 2.5ml (50 drops), in challenging situations under strict medical supervision, up to 4ml (80 drops) of Berodual solution can be used.
Long-term therapy: 1-2ml (20-40 drops) 4 times a day. As an auxiliary during ventilation of the lungs: 0.5 ml (10 drops) of the solution.
For children from 6 to 12 years old:
Relief of an acute attack of bronchial asthma – from 0.5 ml to 1 ml (10-20 drops) with a mild and moderate attack, in complex cases – 2ml (40 drops), in challenging situations under strict medical supervision – 3ml (60 slides);
Long course therapy: 0.5-1ml (10-20 drops) 4 times a day. As an auxiliary during ventilation of the lungs: 0,5ml (10 drops) of the solution.
For children under six years of age (with a bodyweight of less than 22 kg):
The recommended single dose is 0.1 ml (2 drops) of solution per 1 kg of body weight, but not more than 0.5 ml (10 slides); The reception frequency is up to 3 times per day.
Treatment should start with the lowest recommended dose. The necessary amount of solution is diluted with physiological saline to a 3-4 ml volume. Inhalations are carried out with the help of a particular inhalation device: a nebulizer.
Before each inhalation prepares a new solution, you can not use the remaining remedy after the previous procedure. The minimum time interval between the two systems is 4 hours.
Usage and interactions of berodual with other medications
The Berodual should be avoided in combination with the following medications:
Drugs used in the treatment of heart disease, the so-called beta-blockers, such as:
- Bisoprolol.
- Metoprolol.
- Propranolol.
- Atenolol.
- Carvedilol and others.
These medications can block the action of Berodual and can reduce its effects.
Medications that can cause potassium loss, such as:
- Hydrochlorothiazide.
- Furosemide (Lasix).
- Torasemide , and others.
The concomitant use of these medicines with Berodual can cause low potassium levels in the blood and cause serious cardiac arrhythmias (irregular heartbeats). Tell your doctor about all the drugs and herbal products you are taking.
If you use other drugs or over-the-counter products simultaneously, the effects of Berodual may change. This can increase your risk of side effects or make your medication not work correctly.
Tell your doctor about all the medicines, vitamins, and herbal supplements you are using, so your doctor can help you prevent or control drug interactions. Berodual may also interact with the following medications and products:
- Adrenergic agents.
- Anticholinergic agents.
- Diuretics
- Inhibitors of monoamine oxidase.
- Agents are blocking receptors.
- Tricyclic antidepressants.
The medication must be administered with caution in certain diseases and conditions, including:
- Form of angle-closure glaucoma.
- High blood pressure
- Coronary insufficiency.
- Recently he suffered a myocardial infarction.
- Cystic fibrosis.
- Diabetes.
- Severe organic pathologies of the heart and blood vessels.
- Feocromocitoma.
- Hyperthyroidism.
- Hypertrophy of the prostate.
- Cystic fibrosis.
- Obstruction of the neck of the bladder.
- Pregnancy and lactation.
- Age up to 6 years
During the treatment of Berodual, you should keep in mind that:
The Berodual inhibits the contractile activity of the uterus. Fenoterol is absorbed in breast milk, so it is prescribed with caution to nursing mothers
Symptomatic therapy with the Berodual solution may be preferable to long-term treatment (for mild to moderate disease).
