What is a nebulizer used for?
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A nebulizer is a modern inhaler that allows you to obtain a very fine aerosol with a drug. Everyone knows, for example, a “homemade” inhaler - boiled potatoes in a pan covered with a towel.
So, when inhaling the steam formed over potatoes, it only affects the upper parts of the respiratory tract, because the droplets are quite large in size and settle quickly. When using a nebulizer, the aerosol droplets are so small that they penetrate into the lowest parts of the lungs and there they exert their therapeutic effect.
Therefore, the main purpose of using nebulizers is to treat respiratory diseases throughout. Such diseases include bronchitis, tracheitis, laryngitis, pneumonia, sinusitis, and influenza.
Instructions for use BERODUAL
BERODUAL should be used only after a careful assessment of the risk/benefit ratio, especially when used in doses higher than recommended, in the presence of the following diseases:
- uncontrolled diabetes mellitus, recent myocardial infarction, severe organic heart or vascular disease, hyperthyroidism, pheochromocytoma.
In case of sudden development and rapid progression of shortness of breath, you should immediately consult a doctor.
Long-term use of the drug:
- patients with bronchial asthma should use BERODUAL only as needed. For patients with mild chronic obstructive pulmonary disease, symptomatic treatment may be preferable to regular use of the drug.
- Patients with steroid-responsive asthma or chronic obstructive pulmonary disease should be given or increased anti-inflammatory therapy to prevent deterioration of disease control.
Regular use of increasing doses of drugs containing beta2-agonists, such as BERODUAL, to relieve bronchial obstruction can cause uncontrolled worsening of the disease. In case of increased bronchial obstruction, a simple increase in the dose of beta2-adrenergic agonists, including BERODUAL, more than recommended for a long time, is not only not justified, but also dangerous. To prevent life-threatening worsening of the disease, consideration should be given to reviewing the patient's treatment plan and adequate anti-inflammatory therapy with inhaled corticosteroids.
Other sympathomimetic bronchodilators can be prescribed simultaneously with BERODUAL only under medical supervision.
Sympathomimetics, including BERODUAL, may have effects on the cardiovascular system. There are known cases of myocardial ischemia caused by taking beta-agonists. Patients with cardiac pathology (including coronary artery disease, arrhythmias or severe heart failure) taking BERODUAL should consult a doctor if chest pain or other symptoms of cardiac pathology occur. Particular attention should be paid to symptoms such as chest pain and shortness of breath, because... their cause can be both disorders of the respiratory system and the functioning of the heart.
Serious hypokalemia may occur when beta2-agonists are used.
BERODUAL should be used with caution in patients predisposed to angle-closure glaucoma or who have urinary tract obstruction (for example, prostatic hyperplasia or bladder neck obstruction).
There have been isolated cases of ophthalmological complications (mydriasis, increased intraocular pressure, angle-closure glaucoma, eye pain) when nebulized ipratropium bromide alone or in combination with an adrenergic beta2-agonist came into contact with the eyes.
For inhalation, it is recommended to use nebulizers with a mouth tip. When using a nebulizer with a mask, use an appropriately sized mask. Patients predisposed to the development of glaucoma should be especially warned about the need to protect their eyes from contact with the drug.
Eye pain or irritation, blurred vision, halos or colored patterns when the eyes are red as a result of conjunctival hyperemia or corneal edema may be signs of acute angle-closure glaucoma. If any combination of such symptoms progresses, treatment with miotic drops should be started and immediate medical attention should be sought.
People with cystic fibrosis are at increased risk of developing slowed gastrointestinal motility.
When taking BERODUAL, immediate hypersensitivity reactions may occur, such as rash, urticaria, angioedema, oropharyngeal edema, bronchospasm and anaphylaxis.
The use of BERODUAL may lead to positive results for fenoterol in tests for non-clinical use of the drug, for example, when testing athletes for doping.
BERODUAL solution for inhalation contains the preservative benzalkonium chloride and the stabilizer disodium edetate, which, when inhaled, can cause bronchospasm in sensitive patients with airway hyperactivity.
Impact on the ability to drive a car and operate machinery
Studies on the effect of the drug on the ability to drive a car and operate machinery have not been conducted.
However, patients should be warned about the possibility of such side effects during treatment with BERODUAL, such as dizziness, tremor, disturbance of accommodation, mydriasis and blurred vision. Therefore, it is recommended to exercise caution when driving and operating machinery. If patients experience the above side effects, they should avoid such potentially dangerous activities as driving a car or using machinery.
Experts say
At the moment, the best way to treat acute respiratory infections is nebulizers. With their help, you can deliver the necessary medications directly to the site of inflammation - to the bronchi, trachea. It is recommended to start doing inhalations with a nebulizer at a temperature and the first signs of acute respiratory infections - coughing, runny nose, sneezing.
Nebulizers are especially effective in children: their bronchi have a small lumen and, when inflamed, quickly become clogged with the resulting sputum.
Therefore, the answer to the question: is it possible to do inhalation with a nebulizer in children at high temperatures (for example, 38 degrees or more) is definitely positive. The effect is observed literally within the first minutes after inhalation: sputum begins to disappear, a wet cough appears, the condition improves, and after a while the temperature begins to decrease.
In this case, medications administered through a nebulizer are used in such low dosages that they do not have any systemic effect on the human body.
Is it possible to do inhalations with a nebulizer at a fever? Can! Inhalations with this device at a temperature can be used not only for acute respiratory infections, but also for other acute and chronic lung diseases in adults and children, for example, pneumonia, exacerbations of chronic bronchitis, cystic fibrosis. In all cases, there is a reduction in the duration of the temperature period, a rapid improvement in well-being, accelerated recovery, and a reduced need for medication.
Berodual N air 200doses (Behringer)
Contains two components of a combined bronchodilator drug with bronchodilator activity: ipratropium bromide - an m-anticholinergic blocker, and fenoterol hydrobromide - a beta2-adrenergic agonist. With inhaled ipratropium bromide, bronchodilation is due primarily to local rather than systemic anticholinergic effects. Ipratropium bromide is a quaternary ammonium compound. It has anticholinergic (parasympatholytic) properties. Ipratropium inhibits reflexes mediated by the vagus nerve by counteracting the effect of acetylcholine, a neurotransmitter released from nerve endings. Anticholinergics prevent the increase in intracellular concentrations of cyclic guanosine monophosphate (cGMP) in bronchial smooth muscle that occurs when acetylcholine interacts with m-cholinergic receptors. A significant improvement in lung function (increase in FEV1 and average forced expiratory volume flow rate by 15% or more) in patients with COPD with bronchospasm attacks occurs within 15 minutes, the maximum effect is achieved after 1-2 hours and lasts in most patients up to 6 hours after administration. In 40% of patients with bronchospasm associated with bronchial asthma, there is a significant improvement in lung function (an increase in FEV1 of 15% or more). Ipratropium bromide does not have a negative effect on mucus secretion in the respiratory tract, mucociliary clearance and gas exchange. Fenoterol hydrobromide has a direct sympathomimetic effect. In therapeutic doses, it selectively stimulates bronchial β2-adrenergic receptors. At higher doses, it has the ability to stimulate β1-adrenergic receptors. Binding to β2-adrenergic receptors activates adenylate cyclase with the participation of the stimulating Gs protein. Elevated levels of cyclic AMP activate protein kinase A, which then phosphorylates target proteins in smooth muscle cells. This in turn leads to phosphorylation of myosin kinase light chain, inhibition of phosphoinositide hydrolysis, and opening of calcium-activated potassium channels. Fenoterol relaxes the smooth muscles of the bronchi and blood vessels and counteracts the development of bronchospastic reactions caused by the influence of histamine, methacholine, cold air and allergens (immediate hypersensitivity reactions). Immediately after administration, fenoterol blocks the release of bronchoconstrictor inflammatory mediators from mast cells. The use of fenoterol in higher doses increases mucociliary clearance. At higher plasma concentrations of fenoterol, uterine contractility is inhibited. In addition, when used in high doses, metabolic effects are observed: lipolysis, glycogenolysis, hyperglycemia and hypokalemia. Hypokalemia is caused mainly by increased incorporation of potassium ions into skeletal muscles. The beta-adrenergic effect of the drug on cardiac activity, such as an increase in heart rate and strength of heart contractions, is due to the vascular effect of fenoterol, stimulation of β2-adrenergic receptors of the heart, and when used in doses exceeding therapeutic doses, stimulation of β1-adrenergic receptors. As with other beta-adrenergic drugs, prolongation of the QTc interval has been observed when used in high doses. The most commonly observed adverse effect of β2-adrenergic stimulants is tremor. In contrast to the effects on bronchial smooth muscle, tolerance may develop to the systemic effects of β2-adrenergic receptor stimulants. Fenoterol prevents the development of bronchoconstriction caused by various stimuli, such as physical activity, cold air and allergens (immediate hypersensitivity reactions). When ipratropium bromide and fenoterol are used together, the bronchodilator effect is achieved by acting on various pharmacological targets. These substances complement each other, as a result, the bronchodilator effect is enhanced and a greater breadth of therapeutic action is provided for bronchopulmonary diseases accompanied by constriction of the airways. The complementary effect is such that a lower dose of the beta-adrenergic component is required to achieve the desired effect, which facilitates individual dosing of the drug and helps minimize side effects.
