Pharmacodynamics andriol cycle dipropionate is a prodrug and has weak affinity for corticosteroids receptors. Under the action of esterases it is converted to an active metabolite – beklometazona- 17 monopropionat (B-17-MP), which has a pronounced local anti-inflammatory effect. Reduces inflammation by reducing the formation of chemotactic substances (effect on the “late” reaction allergies), inhibits the development of “immediate” allergic reaction (caused -tormozheniem production of arachidonic acid metabolites and decrease the release of mast cell mediators of inflammation) and improves mucociliary transport. Under the influence of andriol cycle decreased the number of mast cells in bronchial mucosa, reduced epithelial edema, mucus secretion of bronchial glands, bronchial hyperreactivity, accumulation of neutrophils boundary, inflammatory exudation and production of lymphokines inhibits the migration of macrophages, reduces the intensity of the processes of infiltration and granulation. It increases the number of active beta-adrenergic receptors, restores the patient’s response to bronchodilators, reduces the frequency of their use. Virtually no resorptive action after inhalation.
Not relieves bronhosiazm therapeutic effect develops gradually, usually after 5-7 days of a course of andriol cycle dipropionate.
Absorption. Up to 56% of the dose of inhaled drug deposited in the lower respiratory tract; the remaining amount is deposited in the mouth, pharynx and swallowed. The light absorption before andriol cycle dipropiopat extensively metabolized to the active metabolite B-17-MP. Systemic absorption of B-17 Megapixel occurs in the lungs (pulmonary fraction 36%) and in the gastrointestinal tract (26% of the dose received here when swallowed). The absolute bioavailability of unchanged andriol cycle dipropionate-17 and B-MP is about 2%, respectively, and 62% of the inhaled dose. Beclometasone dipronionat rapidly absorbed, time to maximum plasma concentration (Tmax) of 0.3 hours. B-17-MP is absorbed slowly. Tmax is I am. There approximately linear relationship between increasing doses of inhaled and systemic exposure of the drug.
Tissue distribution is 20 liters for beklometazoia dipropionate and 424 liters for the B-17-MP. Communication to plasma proteins the relatively high 87%.
Beklometazoia dipropiopat-17 and B-MP have high plasma clearance (150 l / h 120 l / h, respectively). The half-life of 0.5 hours and 2.7 hours, respectively.
Basic therapy of various forms of asthma in adults and children older than 4 years.
Hypersensitivity to any component of the drug. Children under 4 years of age.
Be wary of glaucoma, systemic infections (bacterial, viral, fungal, parasitic), osteoporosis. pulmonary tuberculosis, liver cirrhosis, hypothyroidism, pregnancy, lactation.
Pregnancy and lactation
With caution Beclason Eco Easy Breathing should be used during pregnancy and lactation and only and if the potential benefit to the mother outweighs the potential risk to the fetus and child.
DOSAGE AND ADMINISTRATION
Beclason Eco Easy Breathing is only intended for administration by inhalation. Breath Easy Eco Beclason regularly applied (even in the absence of symptoms), the dose of andriol cycle dipropionate is selected considering the clinical effect in each case.
In less severe asthma forced expiratory volume (FEV1) or peak expiratory flow (PEF) make up more than 80% of the normal value with a spread of PEF less than 20%.
When to moderate FEV1 or PEF is 60-80% from the due sizes, daily disorder of indicators PSV 20-30%.
In severe FEV1 or PEF is 60% from due sizes, daily disorder of indicators PSV of more than 30%.
When you go to a high dose of inhaled andriol cycle dipropionate, many patients receiving systemic corticosteroids, can reduce their dose or stop them altogether.
The initial dose Beclason ECO Easy Breathe determine the severity of asthma. Daily vine is divided into several stages.
Depending on the response of the individual patient, the dose can be increased before the appearance of clinical response or to reduce the minimum effective dose.
Adults and children aged 12 and older children:
The recommended initial dose:
- Asthma easy flow – 200 – 600 mg / day;
- Bronchial asthma moderately severe course of 600 1000 mg / day;
- Bronchial asthma heavy currents – 1000 2000 mg / day.
Children aged 4 to 12 years
Up to 400 mg per day in divided doses.
Special patient groups
There is no need to adjust the dose Beclason ECO Easy Breathe in the elderly, in patients with renal or hepatic insufficiency.
Skipping a single dose of the drug
case of accidental inhalation of skipping the next dose should be taken in due time in accordance with the scheme of treatment.
Beclason ECO Easy Breathe containing 250 mcg dose of 1, it is not intended for pediatric use.
Administration can be carried out using special optimizer improves distribution of the drug in the lungs and reduces the risk of side effects.
Some patients may develop candidiasis of the mouth and throat (likely to develop candidiasis increases when applying bsklometazopa dipropionate at doses exceeding 400 mg per day).
Some patients may experience dysphonia (hoarseness), or irritation of the mucous membrane of the pharynx.
Inhaled medicines may cause paradoxical bronchospasm, which is necessary to stop immediately using inhaled b-2-agonists of short action.
There are some reports about the development of hypersensitivity reactions, including rash, hives, itching, redness and swelling of the eyes, face, lips and mucous membranes of the mouth and pharynx.Possible systemic effects characteristic of glucocorticosteroids. include headache, -toshnotu, bruising or thinning of the skin, unpleasant taste, decreased function of the adrenal cortex, osteoporosis, growth retardation in children and adolescents, cataract, glaucoma.
Acute overdose of the drug can lead to a temporary decrease in the function of the adrenal cortex that requires emergency treatment, since the function of the adrenal cortex restored within a few days, as evidenced by levels of cortisol in the plasma. In chronic overdose may experience persistent suppression of adrenocortical function. In such cases, it is recommended to monitor the backup function of the adrenal cortex. In overdose andriol cycle dipropionate treatment may be continued at a dose sufficient to maintain therapeutic effect.
INTERACTION WITH OTHER DRUGS
No confirmed data on the interaction of andriol cycle dipropionate with other drugs.
Before the appointment of inhaled drugs should instruct the patient on the rules of their application, providing the most comprehensive drug hit in the right lung areas. The development of oral candidiasis is most likely in patients with high blood precipitating antibodies against the fungus Candida, which indicates a previously transferred fungal infection. After inhalation should rinse the mouth and throat with water. For the treatment of candidiasis can be used antifungals local action while continuing therapy Beclason Eco Easy Breathing. Koli Nazis are taking corticosteroids by mouth, then Beclason ECO Easy Breathe appointed in patients receiving the same dose of corticosteroids, while patients should be in a relatively stable state. After about 1-2 weeks the daily dose of oral corticosteroids are gradually reduced.Driving dose reduction depends on the duration of previous therapy, and the magnitude of the initial dose of corticosteroids. Regular use of inhaled corticosteroids in most cases, to cancel oral corticosteroids (patients needing admission no more than 15 mg prednizolopa can be fully transferred to the inhalation therapy), while in the first months after the transfer of the patient should be closely monitored until his pituitary-adrenal the system does not recover sufficiently to provide adequate response to stressful situations (for example, trauma, surgery or infection).
When transferring patients receiving systemic corticosteroids pas inhalation therapy may manifest allergic reactions (such as allergic rhinitis, eczema), which previously suppressed by systemic drugs.
Patients with impaired function of the adrenal cortex, translated into an inhalation treatment, should have a supply of Valium and always carry a warning card, which must be indicated that they are in stressful situations require additional systemic appointment of GCS (after the elimination of stress GCS dose can once again lower). Sudden and progressive deterioration of asthma symptoms is a potentially dangerous condition, often life-threatening patients, and requires increasing doses of corticosteroids. An indirect measure of treatment failure is more frequent than in the past, the use of b-2-agonists of short action.
Beclason Eco Easy Breathing is not for cupping, and for regular daily use. For cupping used p-2-adrsnostimulyatory short-acting (eg, salbutamol). In severe exacerbations of asthma or lack of efficacy of the therapy should increase the dose Beclason Eco Easy Breathing and, if necessary, appoint a systemic corticosteroids and / or antibiotics during infection development.
With the development of paradoxical bronchospasm should immediately discontinue use of Beclason Eco Easy Breathing, to assess the condition of the patient, conduct a survey and assign treatment other medicines if needed. Prolonged use of any inhaled corticosteroids, especially in high doses, may experience systemic effects (see. “Side Effects”), but the probability of their development is much lower than when receiving corticosteroids inside. It is therefore particularly important that the dose of the therapeutic effect of inhaled corticosteroids has been reduced to the minimum effective dose for controlling diseases. The dose of 1500 mg / day in most patients, the drug does not cause significant suppression of adrenal function. Due to possible adrenal insufficiency should be observed, particularly careful and regular monitoring of indicators of adrenocortical function when transferring patients taking corticosteroids by mouth, for treatment Beclason Eco Easy Breathing.
It is recommended to regularly monitor the dynamics of the growth of children receiving inhaled corticosteroids for a long time.
Not recommended abrupt withdrawal Beclason Eco Easy Breathing. It should be particularly careful in the treatment of patients with inhaled corticosteroids ie active or inactive forms of pulmonary tuberculosis. It is necessary to protect the eyes from contact with the drug. Washing after inhalation can prevent skin damage eyelids and nose.
Balloon with Beclason Eco Easy Breathing can not puncture, disassemble or dispose of in fire, even if it is empty. Like most other means of inhalation of aerosol dispensers, Beclason Eco Easy Breathing may be less effective at low temperatures. Upon cooling spray is recommended to get it out of the plastic case and warm hands for a few minutes.
INSTRUCTIONS FOR PATIENT USE inhalers
Instructions for use) inhaler without optimizer
Hold the inhaler in a vertical position, open the cover. Take a deep breath. Firmly grasp the die lips. Ensure that your hand does not block the vents pas top of the inhaler, and that you keep the inhaler in a vertical position. Make a slow maximum inhalation through the mouthpiece. Hold your breath for 10 seconds or as much as you want it. Then, remove the inhaler from the mouth and breathe out slowly. After application, continue to hold the inhaler upright. Close the lid. If you need to make more than one inhalation, close the lid, wait at least one minute, then repeat the process of inhalation.
Instructions on using the inhaler Optimizer
Hold the inhaler in a vertical position, open the cover and push as Optimizer on the mouthpiece of the inhaler. Take a deep breath. Firmly grasp the mouthpiece optimizer lips. Ensure that your hand does not block the vents on the top of the inhaler and that you keep the inhaler in a vertical position. Take a slow breath in through the mouthpiece maximum optimizer. Hold your breath for 10 seconds or as much as you want it. Then, remove the inhaler from the mouth and breathe out slowly. After application, continue to hold the inhaler upright. Remove Optimizer. Close the lid.
If you need to make more than one inhalation, in 1-2 minutes again, open the lid and push as the optimizer on the mouthpiece of the inhaler, and then repeat the process of inhalation.
Cleaning the inhaler
Remove the upper part of the inhaler. Pull the metal canister. Rinse the lower part of the inhaler with warm water and pat dry. Insert the cartridge into place. Close the lid and tighten the upper part of the inhaler to his body. Do not wash the upper part of the inhaler. If the inhaler is not working properly, remove its top and manually click on the balloon.
Aerosol for inhalations dosed activated by inhalation of 50 micrograms / dose, 100 ug / dose, 250 m kg / dose.
200 doses of active substance in aluminum cans filled with pressurized aerosol. Aluminium spray is an aerosol inhaler is activated by inhalation (Breathing Easy).