Berodual solution for inhalation vial 20ml

Mechanism of action

Combined bronchodilator drug, the components of which have different mechanisms and localization of action. The mechanism of action of fenoterol (beta₂-adrenomimetika) is associated with activation of adenylate cyclase coupled with the receptor, which leads to an increase in the formation of c-AMP, which stimulates the work of the Calcium pump. As a result, the concentration of calcium in myofibrils decreases and bronchial dilatation occurs.
Ipratropium bromide is a blocker of m-cholinergic receptors. Effectively eliminates bronchospasm associated with the influence of the vagus nerve, reduces the secretion of glands (including bronchial).
The combination of these substances potentiates the bronchodilator effect and increases its duration. Therefore, it is possible to significantly reduce the dose of the beta-adrenergic component and significantly reduce the risk of its side effects.

Concentrations of active components in blood plasma, detected after inhalation use, correlate with their therapeutic effect.
Plasma concentrations after inhalation administration were 500–1000 times lower than the concentrations observed after administration of equivalent therapeutic doses of the drug inside. The effect of the drug after inhalation use comes faster.

Indications and usage

- basic therapy of chronic obstructive pulmonary disease;
- treatment and prevention of acute asthma attacks in bronchial asthma;
- chronic obstructive bronchitis with or without emphysema;
- prevention of respiratory failure and maintenance therapy for bronchopulmonary diseases with broncho-obstructive syndrome, with hypersensitivity of the bronchi;
- preparation of the respiratory tract for aerosol administration of drugs (mucolytic agents, corticosteroids, antibiotics).

The recommended therapeutic dose of the solution for inhalation is 10-80 drops (0.5-4 ml) 3-6 times a day at intervals of at least 2 hours. When using a nebulizer, 20 drops of the drug should be dissolved in 3 ml of physiological saline and inhaled for 5-7 minutes to full use of the solution.
Therapeutic dose of inhalation solution for children under 6 years old it is 25 mcg ipratropium bromide and 50 mcg fenoterol hydrobromide per 1 kg of body weight, which corresponds to 10 drops (0.5 ml) 3 times / day.
Children from 6 to 12 years appoint from 0.5 to 1 ml (10-20 drops) to 4 times / day. In severe attacks, it is possible to assign 2-3 ml (40-60 drops) under the supervision of a physician.

Adverse reactions

Side effects associated with the action of part of the drug fenoterol: in predisposed patients - tremor of the fingers, palpitations, tachycardia.
Side effects associated with the action of the drug ipratropium bromide: in some cases, dry mouth.

Contraindications

- hypertrophic obstructive cardiomyopathy;
- tachyarrhythmia;
- hypersensitivity to the drug.

Pregnancy and breastfeeding

It is necessary to follow the usual precautions associated with the use of drugs during pregnancy, especially in the first trimester.
It is necessary to consider the possibility of inhibitory action of Berodual on the contractile activity of the uterus.
Caution should be given to Berodual during lactation. It is established that fenoterol is excreted in breast milk. The data confirming that ipratropium bromide is excreted in breast milk has not been obtained.

Special notes

Berodual can be used for concomitant diseases of the cardiovascular system.
The solution for inhalation of Berodual is suitable for simultaneous inhalation with secretion-mucolytic drugs.
In case of accidental ingestion of the drug in the eyes, in some cases, slight accommodation disturbances may occur, which take place independently after a while.

Overdosage

Symptoms: finger tremor, palpitations, tachycardia; With an overdose of the solution for inhalation, an increase in systolic and a decrease in diastolic blood pressure, a feeling of heaviness behind the sternum, sometimes an extrasystole, and an increase in bronchus obstruction are also possible.
Treatment: appointment of tranquilizers, selective beta₁-blockers.

Drug Interactions

With simultaneous use of xanthine derivatives, cromoglicic acid and glucocorticoids enhance the action of Berodual; beta-blockers weaken its effect.

Storage conditions

The drug should be stored at a temperature not exceeding 30 ° C; Do not allow freezing. Shelf life - 5 years.