Bronchodilators and expectorants. Bronchodilators

To alleviate the patient's condition, the doctor prescribes funds to expand the bronchi, depending on what disease the patient has.

general characteristics

They produce drugs in the following forms:

Bronchodilators are used to act on receptors, thereby relaxing the cells in the bronchi, they expand, and spasm is relieved.

Classification of drugs

Drugs that dilate the bronchi are divided into three groups:

The doctor chooses which medicines to prescribe for expanding the bronchi, based on the signs of the disease, the patient's condition, age and contraindications.

Adrenomimetics

Adrenomimetics include such drugs:

Salbutamol

This drug is prescribed for attacks of bronchial asthma, chronic bronchitis. This is a drug that quickly and permanently expands the bronchi (for about 8 hours). Form - tablets, syrups, aerosol, solution for inhalation and injection.

Children over 12 years of age and adults take up to 4 mg three times a day. For inhalation, the powder is added in a dose increased by 2 times. Solutions for inhalation - 2.5 mg each, divided into four doses.

Sometimes there are side effects in the form of tachycardia, tremor, peripheral vessels expand.

There are no contraindications, take with caution with a tendency to hypertension, thyrotoxicosis, childbearing, paroxysmal tachycardia.

Terbutaline

This is a medicine that helps to expand the lumen of the bronchi. Available in the form of tablets, ampoules for injection. Applied during the treatment of asthmatic bronchitis, with bronchial asthma, uterine hypertonicity, with bronchial spasm. Appointed:

Adults maximum 2 tablets (they can be taken in 3 divided doses).
Children from 3 to 7 years old - a quarter or half a tablet.
From 7 to 15 years - half a tablet in 3 doses.
To get rid of an asthma attack, half an ampoule is injected under the skin 3 times a day.

Contraindications: age up to 12 years, bearing a child, lactation.

Fenoterol

Available in the form of an aerosol can, as well as tablets, ampoules for injection. It is prescribed for the treatment of bronchial asthma, with spastic bronchitis, emphysema in the lungs. The dose is selected by the doctor individually. More often, adults and children over the age of six take a dosage of 0.2 mg. If this dose of the drug does not help, you need to repeat after 5 minutes. After only through interval in 6 hours. Prevention of an attack - 0.2 mg (one breath) 3 times a day.

Sometimes causes side effects: fatigue, tachycardia, headaches, excessive sweating. In such cases, you need to reduce the dosage of the drug. There are a number of contraindications - atherosclerosis and arrhythmias.

Fewer complications occur if the patient uses bronchodilators after using inhalers, since a large proportion of the active substances are absorbed in the mouth and the end result is minimal.

Cholinolytics

Berodual belongs to this group of drugs that dilate the bronchi. The drug is prescribed for DN, chronic obstructive bronchitis, bronchospasm, for the treatment of asthma attacks. Aerosol, solution, bottles are produced. Applied by children who are older than 3 years and an adult contingent. Assign 1-2 doses in 3 divided doses. For inhalation, take from 2 to 8 drops, apply a maximum of 6 times a day with a break of 2 hours.

A combination of the drug with corticosteroids and Intal is used, while the effect of the drug is enhanced. You can not take when carrying a child in the 1st trimester and before childbirth, do not prescribe together with Xanthine, beta-blockers.

Methylxanthines

It is customary to include 3 drugs in this group - Eufillin, Diprofillin, Theophylline.

Eufillin is prescribed for bronchospasm, bronchial asthma, hypertension in the pulmonary circulation. Available in powder, tablets, ampoules. A contraindication is a tendency to low blood pressure, paroxysmal tachycardia, epileptic seizures, with heart failure.

Diprofillin is prescribed for coronary spasm, bronchospasm, if hypertension. They produce powder, tablets, ampoules, suppositories. The drug should not be taken with paroxysmal tachycardia, epilepsy, with a decrease in pressure.

Theophylline is available in the form of suppositories and powder. It is prescribed to expand the lumen of the bronchi, to increase the strength of heart contractions, as a diuretic. Take 0.1-0.2 mg up to four times. Rectally used 1-2 suppositories per day. Theophylline is contraindicated in hypersensitivity to the active substance, hyperthyroidism, myocardial infarction. Use with caution in gastrointestinal ulcers.

If the doctor has determined the course of treatment, and it differs from the course indicated in the instructions, then follow the recommendations of the specialist. It is strictly forbidden to change the dosage of bronchodilators at your own discretion.

Bronchodilators: a list of drugs for children and adults

The respiratory system plays a huge role in human life. Various infections and weakened immunity can cause serious illness respiratory organs, while the quality of life of the patient is markedly reduced. Bronchodilators are used to relieve symptoms and treat the causes of the disease. The list of drugs is quite wide, and each remedy has certain properties. Consider how drugs work, classification and appointments for various diseases of the respiratory system.

Who needs bronchodilators

Bronchodilators are classified according to their effect on the respiratory organs. The list of drugs for each disease is selected by the doctor, it depends on the degree of damage and the type of infection.

Bronchodilators are drugs that remove spasms of the bronchi, and at the same time eliminate the very reason why they narrowed. The cause of bronchospasm can be diseases such as:

Bronchial asthma.
About blistering bronchitis.
About acute obstructive bronchitis.
COPD
M ukoviscidosis.
With ciliary dyskinesia syndrome.
B ronchopulmonary dysplasia.

With narrowing of the bronchi.
Bronchial spasms.
H accumulation in the bronchi of mucus.
About fluidity.

Bronchodilators for COPD (drugs, list)

COPD or chronic obstructive pulmonary disease is characterized by progressive, partially reversible bronchial obstruction. It is directly related to inflammation of the respiratory organs, which often arise due to the influence of adverse factors (primarily smoking, pollutants, occupational hazards, etc.). Bronchodilators help in the fight against the disease. The list of drugs for COPD will be as follows:

Betta2-agonists (short action) - "Salbutamol" (analogues - "Salamol", "Ventolin", "Salben", "Salamol Eco").
"Fenoterol" ("BerotekN").
"Formoterol" ("Foradil", "Oxys").
"Salmeterol" ("Salmeter", "Servent").
"Holoinoliki" (short action), as well as combined ones - "Ipratropium bromide" ("A troventN").
Ipratropium bromide + fenoterol (BerodualN).
Long-term action of an anticholinergic - "Tiotropium bromide" ("Spiriva").

Asthma attacks

Which bronchodilators are used for asthma? The list of drugs for this disease contains drugs that relieve sudden attacks, as well as those used for prevention. These include the following bronchodilators:

"Teofillin".
Anticholinergic drugs.
Beta-agonists ("Salbu tamol", "Fenoterol") - short action.

The last two groups are best taken using a nebulizer or inhaler. Sudden asthma attacks require immediate attention. It is necessary to use drugs - bronchodilators, expanding the lumen of the bronchi. This includes beta-agonists. In a matter of minutes, such drugs can alleviate the suffering of the patient: the bronchi open up, the spasm is removed and breathing becomes easier. The effect can last up to 4 hours.

An ebulizer or inhaler makes it possible to relieve an attack at home. This method is the fastest, the medicine enters the bronchi. Taking pills or injections ensures that the drug component enters the blood from the beginning.

Often using bronchodilators to relieve seizures, it should be understood that these are just first aid methods. If you resort to such methods more than twice a week, you should consult a doctor so that he strengthens control over the course of the disease and, possibly, changes the treatment method.

Seizure Prevention

For prophylactic purposes, long-term exposure to bronchodilators is used. The drugs listed below are effective for up to 12 hours, relieving asthma symptoms. The most commonly recommended are:

"Salmeterol" - the effect of the drug is felt 5 minutes after application, can be used for prophylactic purposes. Recommended for adult patients only.
"Formoterol" - also acts quickly. If you need bronchodilators for children, then formoterol is exactly what you need.

Bronchitis treatment

For the treatment of bronchitis, doctors without fail use bronchodilators. This is very important, especially in cases where the disease has flowed into a chronic one, as well as when bronchial obstruction is detected. The attending physician decides which bronchodilators to use. Drugs (the list for bronchitis is quite wide) have a good effect. Most often assigned:

For these drugs, it is better to use a nebulizer or inhalers. In such cases, bronchodilators directly reach the focus of the disease without entering the bloodstream. The impact on the problem becomes immediate and effective. The manifestations of adverse reactions are significantly reduced. It is also important that such procedures are shown to children.

Bronchodilators for pneumonia

Pneumonia is a dangerous infectious disease, usually of bacterial etiology. There is a defeat of the respiratory parts of the lungs, intraalveolar exudation, infiltration of inflammatory cells. The parenchyma is saturated with exudate. Previously absent clinical and radiological signs of local inflammation are revealed.

Pneumonia is treated comprehensively, with bronchodilators included. Drugs (list for pneumonia):

"E ufillin" 2.4% - is administered intravenously-drip 2 times a day, 5-10 ml.
"Atrovent" - 4 times a day for 2 breaths.
"Berodual" - 4 times a day, 2 breaths.

In addition, expectorants are included in the complex treatment of pneumonia: "Acetylcestein", "Lazolvan". In intensive care, bronchodilators and expectorants are administered through a nebulizer.

Treatment for severe pneumonia also includes:

Types of bronchodilators

Bronchodilators-drugs have very different names, below we list them in more detail. As for the types of products, these funds have several groups, the main ones are:

Classification. 1 group

Bronchodilators-drugs (list for asthma, COPD, other lung diseases) are classified into the following groups:

Adrenomimetics. The drugs of this group effectively stop attacks of bronchial obstruction. Activation of adrenergic receptors relaxes the muscles of the bronchi. The list of these bronchodilators will be as follows:

M-anticholinergics. These drugs are also used for attacks of bronchial obstruction, act as blockers. They do not have a systemic effect, do not enter the bloodstream. It is recommended to use only for inhalation. This list includes:

2 group

Phosphodiesterase inhibitors. This group of bronchodilators effectively relaxes the smooth muscles in the bronchi. In the endoplasmic reticulum, calcium is deposited, due to the fact that its amount decreases inside the cell. This improves the functions of the diaphragm, peripheral ventilation. This group includes:

These drugs can cause tachycardia, dizziness, a sharp drop in blood pressure.

Mast cell membrane stabilizers. This group is used for prophylactic purposes to contain bronchial spasms. Calcium channels are blocked, an obstacle is formed at the entrance of mast cells for the passage of calcium. Thus, the release of histamine, degranulation of mast cells is disrupted. If the attack has already begun, the drugs of this group will no longer be effective. Preparations:

3 group

Corticosteroids. This group is used to treat a complex form of bronchial asthma. In some cases, it is possible to use it for prevention, as well as to relieve an onset asthma attack. Group 3 includes b roncholytics - drugs (with a squeak):

Calcium channel blockers. This group is used in the relief of attacks of bronchial obstruction. The drugs act on calcium channels, blocking them, calcium does not penetrate into the cell. Due to this, relaxation of the bronchi occurs. Spasms decrease, peripheral and coronary vessels dilate. This group includes:

4 group

Antileukotriene drugs. When taking these bronchodilators, leukotriene receptors are blocked. This contributes to the complete relaxation of the bronchi. These drugs are used to prevent the occurrence of attacks of bronchial obstruction. The drugs have a great effect in the treatment of diseases that have arisen against the background of long-term use of NSAIDs. List of drugs in this group:

It should be noted that all groups of bronchodilators are mainly aimed at relaxing the bronchi. In order to prescribe an effective treatment, the doctor must take into account concomitant diseases, the characteristics of the body, as well as the properties of bronchodilators.

Side effects

Using bronchodilators of a particular group, you need to know about the side effects that they can cause. After taking short-acting bronchodilators ("Fenoterol", "Terbutaline", "Salbutamol"), the following undesirable consequences are possible:

Headache.
Dizziness.
T remorse of limbs, twitching.
With palpitations, tachycardia.
Nervous excitement.
And the rhythm.
hypokalemia.
Hypersensitivity.

Long-acting drugs ("Formoterol", "S al meterol") most often have the following side effects:

Sleep disorders.
Nausea.
Headache.
Dizziness.
hypokalemia.
T remor of legs, arms.
With a heartbeat.
And a change in taste.
Muscle twitching.
In severe form, the development of paradoxical bronchospasm is possible.

If you experience any side effects after using the drug, you should contact your doctor to review the treatment and prescribe other drugs.

Contraindications

There are diseases in which the use of short-acting bronchodilators is simply unacceptable, such diseases include:

In the presence of these diseases, care should be taken when taking bronchodilators of other groups. It should also be noted that pregnant women, if necessary, should choose short-acting bronchodilators. Theophylline, which has a prolonged effect, is recommended only in the second trimester, no more than one tablet per day. Already before childbirth (for three weeks), long-acting bronchodilators should be excluded. With caution, use bronchodilators and nursing mothers.

Pay special attention to how bronchodilators are prescribed to children. The list for children is not as extensive as for adults. Before using this or that drug, be sure to consult a pediatrician. Usually children are prescribed inhaled bronchodilators.

When using bronchodilators -preparations, strictly observe the dosage so as not to harm your own health.
If children are being treated with a nebulizer or inhaler, the presence of adults is mandatory.
Persons with cardiac arrhythmias, diabetes mellitus, high blood pressure, and glaucoma should be especially careful in the treatment of bronchodilators.
Caution when taken concomitantly with sympathomimetics. In possible development of hypokalemia with simultaneous appointment with corticosteroids, theophyllines, diuretics.
Bronchodilators are used strictly according to the prescription of the attending doctor. Remember, self-medication is dangerous for your health.

Bronchodilators for children

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RULES FOR INHALATIONS: 1. Inhalations should be taken no earlier than 1-1.5 hours after eating, and you should not be distracted by conversation. After inhalation for 1 hour, it is not recommended to talk, eat, go outside (in cool weather). 2. In diseases of the upper respiratory tract (nose, paranasal sinuses and nasopharynx), inhalation and exhalation must be done through the nose using a mask. Breathe calmly, without tension. 3. In diseases of the middle respiratory tract (throat, larynx), inhalation and exhalation should be done through the mouth using a mask. Breathe.

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1. Drugs that dilate the bronchi (Broncholytics) Berodual, active ingredient: fenoterol and ipratropium bromide (solution for inhalation) - Prevention and treatment of suffocation in chronic obstructive airway diseases. The most effective of bronchodilator drugs, has the least side effects. Adults and children over 12 years old - 2 ml (40 drops) of the drug for 1 inhalation, up to 4 times a day Children from 6 to 12 years old - 1 ml (20 drops) of the drug for 1 inhalation, up to 4 times a day Children under 6 years old -.

1. Drugs that dilate the bronchi (Broncholytics)

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SOLUTIONS FOR THE NEBULIZER 1. DRUGS DILATIVE BRONCH (BRONCHOLITICS) Berodual, active ingredient: fenoterol and ipratropium bromide (solution for inhalation) - Prevention and treatment of suffocation in chronic obstructive airway diseases. The most effective of bronchodilator drugs, has the least side effects. Adults and children over 12 years old - 2 ml (40 drops) of the drug per 1 inhalation, up to 4 times a day; Children from 6 to 12 years old - 1 ml (20 drops) of the drug per 1 inhalation, up to 4 times a day;

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SOLUTIONS FOR INHALATORS (NEBULIZERS)

Solutions for nebulizers (inhalers) Recipes for a nebulizer RULES FOR INHALYATIONS: 1. Inhalations should be taken no earlier than 1-1.5 hours after eating, and you should not be distracted by conversation. After inhalation for 1 hour, it is not recommended to talk, eat, go outside (in cool weather). 2. In diseases of the upper respiratory tract (nose, paranasal sinuses and nasopharynx), inhalation and exhalation must be done through the nose using a mask. Breathe calmly, without tension.

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1. DRUGS TO DILATE THE BRONCH (BRONCHOLITICS)

SOLUTIONS FOR INHALATORS (NEBULIZERS) 1. Drugs that dilate the bronchi (Broncholytics) Berodual, active ingredient: fenoterol and ipratropium bromide (solution for inhalation) - Prevention and treatment of suffocation in chronic obstructive airway diseases. The most effective of bronchodilator drugs, has the least side effects. Adults and children over 12 years old - 2 ml (40 drops) of the drug per 1 inhalation, up to 4 times a day Children from 6 to 12 years old - 1 ml (20 drops) of the drug per 1 inhalation, up to 4 times a day Children.

RULES FOR INHALATIONS: Inhalations should be taken no earlier than 1-1.5 hours after eating, and you should not be distracted by conversation. After inhalation for 1 hour, it is not recommended to talk, eat, go outside (in cool weather). In diseases of the upper respiratory tract (nose, paranasal sinuses and nasopharynx), inhalation and exhalation must be done through the nose using a mask. Breathe calmly, without tension. In diseases of the middle respiratory tract (throat, larynx), inhalation and exhalation should be done through the mouth using a mask. You should breathe calmly.

SOLUTIONS FOR INHALATORS (NEBULIZERS)SOLUTIONS FOR INHALATORS (NEBULIZERS)1. Drugs that dilate the bronchi (Broncholytics) Berodual, active ingredient: fenoterol and ipratropium bromide (solution for inhalation) - Prevention and treatment of suffocation in chronic obstructive airway diseases. The most effective of bronchodilator drugs, has the least side effects. Adults and children over 12 years old - 2 ml (40 drops) of the drug per 1 inhalation, up to 4 times a day; Children from 6 to 12 years old - 1 ml (20 drops) of the drug per 1 inhalation, up to 4 times a day; Children under 6.

Before using drugs, be sure to consult a specialist. Only a specialist is able to choose the right drug and its dosage. SOLUTIONS FOR INHALATORS (NEBULIZERS)1. Drugs that dilate the bronchi (Broncholytics) Berodual, active ingredient: fenoterol and ipratropium bromide (solution for inhalation) - Prevention and treatment of suffocation in chronic obstructive airway diseases. The most effective of bronchodilator drugs, has the least side effects. Adults and children over 12 years old - 2 ml (40 drops) of the drug per 1 inhalation, up to 4 times a day. Children from 6 to 12 years old - 1.

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1. DRUGS EXPANDING THE BRONCH (BRONCHOLITICS) Berodual, active ingredient: fenoterol and ipratropium bromide (solution for inhalation) - Prevention and treatment of suffocation in chronic obstructive airway diseases. The most effective of bronchodilator drugs, has the least side effects. Adults and children over 12 years old - 2 ml (40 drops) of the drug for 1 inhalation, up to 4 times a day Children from 6 to 12 years old - 1 ml (20 drops) of the drug for 1 inhalation, up to 4 times a day Children under 6 years old -.

Inhalations for runny nose and colds Medicines for use in inhalers and nebulizers Natural and essential oils Inhalation of essential oils - effective method aromatherapy. Care should be taken to use different oils, the selection of oils should be individual. Before using essential oils, be sure to consult your doctor. When using essential oils, their concentration should not exceed 5%. Alkaline solutions Sodium bicarbonate. A 2% solution is used to thin the mucus and create an alkaline environment in the focus of inflammation. Ten-minute inhalation increases the efficiency of removing mucopurulent discharge from the nasal cavity.

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SOLUTIONS FOR THE NEBULIZER 1. DRUGS DILATIVE BRONCH (BRONCHOLITICS) Berodual, active ingredient: fenoterol and ipratropium bromide (solution for inhalation) - Prevention and treatment of suffocation in chronic obstructive airway diseases. The most effective of bronchodilator drugs, has the least side effects. Adults and children over 12 years old - 2 ml (40 drops) of the drug for 1 inhalation, up to 4 times a day Children from 6 to 12 years old - 1 ml (20 drops) of the drug for 1 inhalation, up to 4 times a day Children up to.

The list of drugs allowed when using nebulizers

The list of drugs allowed when using nebulizers With a dry cough, it is necessary to soften the sore throat, reduce the viscosity of the mucus and remove it from the bronchi or lungs. In this case, under the supervision of a doctor, they resort to inhalation using:

SOLUTIONS FOR INHALATORS (NEBULIZERS)

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Among all pathologies, diseases associated with bronchial lesions are very common. For example, bronchitis, bronchial asthma, lung obstruction, pleurisy, bronchiectasis. To alleviate the patient's condition, the doctor prescribes funds to expand the bronchi, depending on what disease the patient has.

They produce drugs in the following forms:

Pills.
Inhalers.
Injections.
Powders.

Bronchodilators are used to act on receptors, thereby relaxing the cells in the bronchi, they expand, and spasm is relieved.

Classification of drugs

Drugs that dilate the bronchi are divided into three groups:

Anticholinergics.
Adrenomimetics.
Methylxanthines.

The doctor chooses which medicines to prescribe for expanding the bronchi, based on the signs of the disease, the patient's condition, age and contraindications.

Adrenomimetics

Adrenomimetics include such drugs:

Salbutamol.
Terbutaline.
Fenoterol.

Consider each of these drugs, as well as the course of administration indicated in the instructions (the doctor gives each patient individual prescriptions).

Salbutamol

Sometimes there are side effects in the form of tachycardia, tremor, peripheral vessels expand.

There are no contraindications, take with caution with a tendency to hypertension, thyrotoxicosis, childbearing, paroxysmal tachycardia.

Terbutaline

Adults maximum 2 tablets (they can be taken in 3 divided doses).
Children from 3 to 7 years old - a quarter or half a tablet.
From 7 to 15 years - half a tablet in 3 doses.
To get rid of an asthma attack, half an ampoule is injected under the skin 3 times a day.

Contraindications: age up to 12 years, bearing a child, lactation.

Fenoterol

Fewer complications occur if the patient uses bronchodilators after using inhalers, since a large proportion of the active substances are absorbed in the mouth and the end result is minimal.

Cholinolytics

Methylxanthines

It is customary to include 3 drugs in this group - Eufillin, Diprofillin, Theophylline.

If the doctor has determined the course of treatment, and it differs from the course indicated in the instructions, then follow the recommendations of the specialist. It is strictly forbidden to change the dosage of bronchodilators at your own discretion.

In diseases of the respiratory tract, accompanied by spasms of the bronchi, such as asthma (COPD), bronchitis, special bronchodilators are prescribed. Previously, the most effective remedy in this group was adrenaline, which has a lot of side effects. Today's advances in medicine make it possible to almost completely abandon its use.

Drugs with a bronchodilatory effect

Existing medicines include 2 classes of chemicals:

anticholinergics;
adrenomimetics (adrenergic stimulants).

The first type of bronchodilator drugs acts on receptors that are responsible for irritating nerve endings. The second type produces the direct effect of blocking the spasm by expanding the tissues of the bronchi. Therefore, anticholinergics are never prescribed as monopreparations, they are used only in combination with adrenomimetics.

It is also worth noting that the result of the work of adrenostimulators is observed within 15-20 minutes after ingestion. This indicator in anticholinergics is from 30 to 50 minutes, but their action is longer.

Bronchodilators for bronchitis

The considered group of drugs is prescribed, as a rule, for the treatment of chronic obstructive bronchitis.

Anticholinergics:

Troventol;
Atrovent;
Truvent.

The advantages of these bronchodilators for inhalation are considered to be a small number of side effects, the absence of negative impact to the cardiovascular system.

In parallel, you need to use beta-2 antagonists (adrenomimetics):

Fenoterol;
Salbutamol;
Berotek;
Ventolin.

Particular attention should be paid to the modern combined medication, which combines adrenostimulants and anticholinergics -. It is based on 2 active components that mutually reinforce each other's action, therefore, so far it is the most effective.

Also, the doctor may advise the theophylline group (methylxanthines):

Theotard;
Teolek;
Durophyllin;
slowfillin;
Euphylong;
Retafil.

Bronchodilator drugs for asthma

Albuterol;
Fenoterol;
Terbutaline.

They are equally highly effective and relatively safe.

If it is impossible to use one of the three indicated drugs, you can purchase:

Salbutamol;
Berotek;
Ventolin;
Serevent;
Bricanil;
Asthmopent;
Isadrin;
Foradil;
Alupent;
Broncaid Mist;
Novodrin.

Among anticholinergics, doctors advise 4 drugs:

Trouvent;
Ventilat;
Atrovent;
Oxyvent.

Bronchodilators for COPD

With exacerbation of chronic obstructive pulmonary disease and remission, individually selected treatment regimens are used, which include the following:

Truvent and Atrovent (anticholinergics);
albuterol-based adrenostimulant drugs (Ventolin and Salbutamol);
Fenoterol.

In rare cases, in severe pathology, methylxanthines are additionally prescribed, in particular, Eufilong and Teolek.

Bronchodilator folk remedies

When using such drugs, it should be borne in mind that they do not produce the same quick effect as adrenomimetics and even anticholinergics, they only help with long-term use.

Ginger tincture:

Garlic-lemon infusion:

Grind five lemons and 2 heads of garlic, mix with 1 liter of water, slightly cool or at room temperature.
Insist 5 days without placing in the refrigerator.
Strain the drug.
Drink 3 times a day, 1 tablespoon approximately 20 minutes before meals.

All diseases that affect the respiratory tract significantly reduce the quality of human life. Therefore, a wide range of therapeutic agents is used to treat them and eliminate unpleasant symptoms. Bronchodilator drugs are often used in medical practice.

Bronchodilators are symptomatic drugs. They are used to eliminate shortness of breath, asthma attacks and spasms localized in the airways. However, they do not directly affect the cause that led to this condition. Bronchodilators only affect the muscle tone of the bronchi, which brings relief.

Medicines of this type help to cope with the following symptoms:

swelling of the mucous membrane of the respiratory tract;
accumulation of mucus in the bronchi;
development of bronchial spasms;
narrowing of the bronchial lumen.

What diseases are bronchodilators indicated for?

Bronchodilators are actively used to eliminate negative symptoms in the presence of such diseases:

bronchial asthma;
chronic obstructive pulmonary disease;
obliterating bronchitis;
cystic fibrosis;
bronchopulmonary dysplasia;
ciliary dyskinesia syndrome;

It is possible to use bronchodilator drugs for prophylactic purposes with the possibility of developing a different nature of origin.

Bronchodilators - short-acting drugs, are contraindicated in the presence of the following diseases:

any cardiac pathology;
diabetes;
arterial hypertension;
violation of the thyroid gland, in which excessive production of hormones is observed;
cirrhosis of the liver.

If a person has one of these diseases, he needs to be especially careful when taking other groups of bronchodilators.

Possible contraindications during pregnancy, lactation and in the treatment of children

Pregnant women should use short-acting drugs to eliminate bronchospasm. The use of bronchodilators with a prolonged effect is possible only in the second trimester, no more than one tablet per day. At the same time, in the last month of pregnancy, the use of such drugs should be completely excluded. During lactation, bronchodilator drugs should be used very carefully (avoid if possible).

For the treatment of children, separate groups of bronchodilators are prescribed. The use of any drug should be agreed with the doctor based on the condition of the child. Most often, children are prescribed inhaled bronchodilators.

Types of bronchodilators

Means of bronchodilator effects are divided into several groups according to different criteria.

Classification based on dosage form

According to this criterion, bronchodilators are divided into the following types:

syrups;
pills;
aerosol means;
solutions for injection;
nebulizers.

Classification based on the method of exposure to the organs of the human respiratory system

Inhaled and oral bronchodilators are divided into such groups based on the method of exposure to a person.

Andrometics

Andrometics are actively used to eliminate attacks of bronchial obstruction, which is observed in bronchitis and other diseases of the respiratory system. The substances that make up this group of bronchodilators reduce the activity of adrenoreceptors. This is what weakens the muscles of the bronchi.

The list of popular bronchodilators related to andrometics is as follows:

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M-anticholinergics

M-anticholinergics have the same effect as andrometics. These funds do not produce a systemic effect on the body and do not enter the blood plasma. These bronchodilators are available in the form of aerosols. The list of M-anticholinergic drugs is as follows:

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Phosphodiesterase inhibitors

Bronchodilators of this type help to relax the smooth muscles located on the surface of the bronchi, due to the decalcification of cells. Calcium is stored in the endoplasmic reticulum. As a result, a significant decrease in its concentration inside the cell is observed. This leads to improved functioning of the diaphragm, increased peripheral ventilation.

These bronchodilators include the following drugs:

When taking these bronchodilators, you should be especially careful. They can cause a sharp decrease in blood pressure, dizziness, increased heart rate and other undesirable consequences.

Mast cell membrane stabilizers

Bronchodilators from this group are used only for preventive purposes for containment. They act on calcium channels, blocking the passage of calcium through them. This prevents the production of histamine and cell degranulation.

When using such bronchodilators, one must not forget that they are effective only for the prevention of seizures. For example, with an exacerbation of bronchitis, these drugs will not help to cope with bronchial obstruction. Bronchodilators SMTK are available in the form of tablets or aerosols.

The drugs in this group include:

Nedocromil.

Corticosteroids

Bronchodilators of this type can be used to treat or prevent various diseases. Doctors often prescribe corticosteroids to treat severe asthma. The list of drugs belonging to this group is as follows:

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Calcium channel blockers

Bronchodilators of this type are mainly used to relieve acute attacks of suffocation. They block calcium channels, which prevents calcium from entering the cells and relaxes the smooth muscles of the bronchi. When using these bronchodilator drugs, spasms are eliminated, there is an improvement in blood flow in the vessels. The most popular means from this group are Nifedipine, Isradipine.

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Means of antileukotriene action

The drugs act on leukotriene channels and block them. As a result, relaxation of the bronchi is observed. Most often, such bronchodilators are used to prevent obstructive processes. They are especially effective in the treatment of pathologies that have arisen against the background of long-term use of NSAIDs. Popular drugs in this group include Montelukast and Acolat.

Popular bronchodilators of different groups

Pharmaceutical companies produce many simple and combined drugs of different modes of action that help to cope with bronchospasms or prevent their development.

Sold in different pharmaceutical forms:

syrup;
pills;
powder;
aerosol.

This drug has a short action, so it is not used for prophylactic purposes.

Most often it is used in the treatment of diseases accompanied by spastic conditions. After the onset of an asthma attack, it is recommended to take 1-2 doses of the drug and, if necessary, repeat the use of the drug (in case of severe disease).

T A drug like Spiriva comes in the form of a powder for inhalation. It is used for maintenance therapy in the presence of COPD, etc. It is forbidden to use it in the first trimester of pregnancy, and in 2-3 - only if there are strict indications.

The medicine is used in the form of inhalation, for which a special HandiHalera device is additionally used. The capsules do not need to be swallowed.

Combined drug with a bronchodilator effect. It contains several active components, which allows to achieve a better result in the prevention and treatment of various diseases accompanied by bronchial obstruction.

The drug is available in the form of a solution, which is taken by inhalation. For this, a nebulizer is additionally used. When using aerosols, it is recommended to take two doses of the drug at a time.

The drug is taken in the form of tablets, powder, administered intravenously or intramuscularly. It is mainly used to relieve asthma attacks caused by bronchial or cardiac asthma.

Taking a bronchodilator is contraindicated in low blood pressure, epilepsy, heart failure, and some other conditions. Therefore, Eufillin and similar drugs should be prescribed only by a doctor.

A bronchodilator drug is used to prevent exacerbations in bronchial asthma and allergic rhinitis. The product is available in the form of a powder, which is used for inhalation. At the beginning of treatment, up to 4 procedures per day are prescribed. In the absence of a positive result or with strong exposure to the allergen, up to 8 inhalations per day are allowed.

During pregnancy, the drug is allowed, but only at a later date. In the first three months, treatment with Cromolyn is undesirable.

Available in the form of a powder, which is used for the preparation of solutions for injection or for intravenous administration. A bronchodilator is used to relieve status asthmaticus or severe allergic reactions that are not amenable to traditional treatment.

Hydrocortisone is used to eliminate suffocation, after which they switch to therapy with other drugs that do not cause sodium retention in the body. It is allowed to use the drug for the treatment of children, taking into account age, body weight, severity of the condition.

Bronchodilator drug, which is available in the form of tablets. The tool can be used to treat children over the age of 2 years. The first positive result after taking a bronchodilator is observed a day after taking the first pill. To consolidate the achieved effect, treatment with the drug should be continued for some more time and follow other recommendations of doctors.

Bronchodilators (synonyms: bronchodilators, bronchodilators, bronchodilators)

drugs of different pharmacological classes, combined into one group according to their common elimination, acting on the bronchial muscles and various links of its regulation. This group does not include agents whose bronchodilator effect is due to the action on pathological processes that cause bronchial obstruction, for example, allergies (, ketotifen, etc.).

The tone of the bronchial muscles is formed by a balance of constrictor influences (through the adenosine and m-cholinergic receptors of the bronchi) and dilating - mainly through cAMP, the amount of which in the bronchial muscles is determined by the ratio of its synthesis (stimulated by the excitation of β 2 -adrenergic receptors) and decay under the influence of phosphodiesterase. Accordingly, B. s. are represented mainly by drugs of the following three groups: 1) β 2 -agonists, 2) m-anticholinergics, 3) xanthine derivatives - myotropic, blocking the bronchoconstrictor effects of adenosine and inhibiting phosphodiesterase.

Adrenomimetics make up the largest number of drugs used as B. s. Non-selective α + β-adrenergic agonists (to relieve an asthma attack) and ephedrine, and isadrin and orciprenaline that affect β 1 + β 2 -adrenergic receptors (see Adrenomimetic agents), are also used, but the leading place among the drugs in this group is occupied by selective β 2 -adrenostimulants hexoprenaline, salbutamol, saventol, salmeterol, terbut aline, fenoterol, formoterol. Unlike ephedrine and isadrine, selective β 2 -agonists, when used correctly in doses that eliminate bronchospasm, change the pulse rate and other functions associated with the excitation of β 1 - and α 1 -adrenergic receptors much less (see Receptors). The selectivity of the bronchodilator action is further enhanced by the use of these agents in the form of metered inhalations of their aerosols from cylinders or powder from special dispensers (spinhaler, turbuhaler), which limits the overall resorption of the adrenomimetic, but if it is not properly inhaled from the oral cavity, it can significantly weaken this advantage. As the dose increases, the selectivity of the action of all drugs decreases. General contraindications to the use of B. s. from the group of adrenomimetics are up to 2 years, extrasystole, aortic, glaucoma, unstable sugar, the first trimester of pregnancy.

Hexoprenaline(ipradol) - tablets of 0.5 mg, dosed for inhalation (1 - 0.25 mg), 2 ml ampoules (5 mg), for children (0.125 mg in 5 ml). Application: 1-2 inhalations or 1-2 tablets orally up to 3 times a day; in children - according to the attached scheme, depending on age.

Salbutamol(ventolin, salamol, etc.) - tablets 2 and 4 mg(prolonged action Volmax - 4 and 8 mg), for inhalation from a spinhaler (1 dose - 0.2 or 0.4 mg), metered aerosol (1 dose - 0.1 mg), for inhalations and injections (1 mg in 1 ml). The drug is inhaled for 1-2 breaths (the effect appears after 5-10 min) no more than 6 times a day; inside apply 8-16 mg per day. Salbutamol is considered a highly selective β 2 -agonist, however, tachycardia and overdose are often encountered in practice; nausea, are also possible. It is part of the combined preparations "Teo-Astakhalin", "Combivent" (see below).

saventol(saltos) - a derivative of salbutamol; domestic drug of prolonged action (up to 7-9 h) in the form of tablets with a gradual release of the active substance, like in Volmax (6 mg) in the gastrointestinal tract from the tablet core. Application: 1 tablet 2 times a day.

Salmeterol(salmeter, serevent) - the most selective agonist of β 2 -adrenergic receptors of the bronchi, which also reduces histamine, leukotrienes, prostaglandin D 2 by mabrocytes, which contribute to bronchoconstriction in patients with bronchial asthma. Available in the form of a metered aerosol (1 dose - 25 or 50 mcg). The bronchodilating effect appears after 5-10 min after inhalation and lasts up to 12 h in connection with the structural features of the salmeterol molecule, the active part of which interacts with the receptor for a long time, due to the deep penetration of its other part into the hydrophobic region of the cell membrane. Application: 1-2 inhalations 2 times a day. Salmeterol is hydrolyzed in the liver and slowly (up to 170 h) is eliminated from the body through the gastrointestinal tract (about 60%) and by the kidneys. Despite the high selectivity of the drug, tachycardia and tremor, as signs of an overdose, are observed in 2-3% of cases with inhalations of 50 mcg and in 7-8% - with inhalations of 100 mcg.

Terbutaline(brikanil) - tablets of 2.5 and 5 mg, injection solution (ampoules - 0.5 mg in 1 ml), powder for inhalation in a turbuhaler (1 dose - 0.5 mg), metered aerosol (1 dose - 0.25 mg). After inhalation of the drug, the bronchodilatory effect develops after 5-10 min and lasts up to 4-4 1/2 h. Application: 1-2 breaths of aerosol up to 4 times a day; inside - 2.5-5 mg up to 3 times a day.

Fenoterol(berotek) more often than other selective β 2 -agonists causes β 1 -adrenergic effects, approaching orciprenaline in this action. Available in tablets (5 mg), concentrated solutions for infusion, dosed powders (0.2 mg) and metered aerosols (1 dose - 0.1 or 0.2 mg) for inhalation. bronchodilatory effect develops after 5 min after inhalation and lasts up to 6-8 h.

Formoterol due to the peculiarities of the chemical structure, it has a long bronchodilatory effect (from 8 to 12 h) after oral administration (tablets of 20, 40 and 80 mg), and in inhalation (metered aerosol of 12 mcg). According to some reports, formoterol reduces the release of biologically active substances from mastocytes and basophils, increases mucociliary, can enhance the effect of MAO inhibitors and tricyclic antidepressants.

m-anticholinergics had limited use as B. s. due to an adverse effect on mucociliary clearance and other manifestations of a generalized blockade of m-cholinergic receptors (tachycardia, dry mouth, etc.), including central anticholinergic effects. The main indications for their use were bronchospasm caused by the use of β-blockers or poisoning with cholinomimetic substances, or a pronounced individual bronchodilating effect of atropine, detected in a patient during pharmacological tests. At the same time, preference was given to the use of metacin, which does not penetrate through (see Anticholinergics), or the inhalation method of administering atropine (fine aerosol), if the main ones were absent - glaucoma, urinary retention (in particular, with prostate adenoma), tachycardia, difficult discharge of viscous sputum.

Wider use as B. with. received newly created m-cholinolytics that do not penetrate into the central nervous system. and practically devoid of resorptive action when inhaled due to poor absorption. These include ipratorium bromide (an isopropyl derivative of atropine) and the domestic drug troventol, which is close to it in chemical structure.

Ipratorium bromide(Atrovent) - metered aerosol (1 dose - 0.02 mg) and dosed powder (0.2 mg capsule) for inhalation. The bronchodilatory effect after inhalation develops slowly (within 30 min), reaches a maximum after 2 h and continues around 6 h. The drug is effective both in bronchospasm (especially reflex) in patients with bronchitis, and in a simple attack of bronchial asthma. Undesirable effects are practically absent; there may be complaints of some dryness and bitterness in the mouth. the advantages of using the drug in elderly patients are noted. If the aerosol gets into the eyes, accommodation disturbances and an increase in intraocular pressure (for those suffering from glaucoma) are possible. Application: inhalation 1-2 doses up to 3 times a day.

Troventol(Truvent) - metered aerosol for inhalation (1 dose - 0.04 or 0.08 mg). By its properties and action is similar to atrovent.

xanthine derivatives are non-competitive ligands of adenosine receptors A 1 and A 2 . They increase A 2 receptors (decreased in bronchial asthma) and block A 1 mediating bronchoconstriction. This effect is complemented by inhibition of phosphodiesterase, which leads to accumulation of cAMP in cells (as with the use of β-agonists) and bronchodilation. In addition, xanthine derivatives excite the central nervous system, respiratory, improve impaired diaphragmatic, increase adrenaline from the adrenal glands, increasing the level of β-adrenergic processes in the body, and inhibit the release of allergy mediators by mast cells. They improve the capillary of the brain, increase the work of the heart (simultaneously expanding the coronary arteries) and its need for oxygen, increase.

As B. with. mainly theophylline (in different dosage forms) and its derivatives (diprofillin) are used. There are short-acting drugs of this group (eufillin, diprofillin, theophylline in powder) and long-acting theophylline preparations. All of them are metabolized in the liver and excreted (partly unchanged) by the kidneys; penetrate the placenta and into. In case of an overdose, they can cause nausea, vomiting, convulsions, ventricular extrasystoles. Common contraindications to their use are, extrasystole, acute, subaortic stenosis, hyperthyroidism, the period of breastfeeding a child. They are used with caution in children, in patients with peptic ulcer, in violation of the functions of the liver and kidneys, as well as against the background of the use of cardiac glycosides (summation of arrhythmogenic action).

Eufillin- theophylline preparation in combination with 1,2-ethylenediamine, which contributes to the solubility of theophylline in water. When taken orally, it is irritating and less absorbed than theophylline (absorption improves when the drug is taken in an alcoholic solution), but water solubility has made it possible to create forms for parenteral administration. Available in tablets of 0.15 G, in the form of a 2.4% solution in ampoules of 10 ml for intravenous administration and 24% solution in 1 ampoules ml(containing in the drug "diafillin" also 0.01 G anestezin) - only for intramuscular injection. Aminophylline is used mainly intravenously (slowly) for the relief of bronchospasm. The bronchodilatory effect is manifested in the first 10 min after the introduction and continues 2-4 h. Intramuscular application does not significantly change the duration of action.

Diprofillin, or 7-(2,3-dioxypropyl)-theophylline, is available in tablets of 0.2 G, in the form of a 10% solution in ampoules of 5 ml for intramuscular injection (for slow intravenous administration, the contents of the ampoule are diluted in 15 ml water for injection) and in the form of rectal suppositories of 0.5 G. Unlike eufillin, the drug does not irritate tissues and can be used to prevent bronchospasm during the day (ingestion) and at night (application in candles).

Theophylline- an alkaloid contained in coffee, tea leaves and obtained synthetically. Produced in powder and in candles (0.2 G). Moderately irritating to mucous membranes. When taken orally, it is rapidly absorbed; bronchodilatory effect appears after about 30 min, reaches a maximum after 90-120 min and lasts 3-4 h. For the prevention of bronchospasm, it is used in a single dose of 2.5-3 mg/kg body weight up to 4 times a day (for the first dose, a "saturating" dose is recommended at the rate of 4-5 mg/kg). In the form of rectal suppositories, theophylline is absorbed faster, bronchodilation occurs earlier, but the risk of overdose increases. Theophylline is part of the combined preparations "Teo-Astakhalin", "Teofedrin-N" and others (see below).

Long-acting theophylline preparations are mostly created on the principle of combining the active substance with biosoluble polymers. The latter provide a slow release and absorption of theophylline in the gastrointestinal tract. More than 20 such drugs have been proposed in tablets or capsules, a single dose of which creates and maintains a therapeutic concentration of theophylline in the blood for 8-12 h(ventax - capsules of 0.1, 0.2 and 0.3 G; retafil - tablets 0.2 and 0.3 G; theobiolong - 0.1 each G; teopek - tablet 0.3 G; teotard - tablets of 0.1, 0.2 and 0.3 G; etc.) or almost a day (teodur-24 - capsules of 1.2 and 1.5 G; Unifil - tablets of 0.2 and 0.4 G; eufilong - capsules of 0.25 and 0.375 G; and etc). For round-the-clock provision of a bronchodilator effect, these drugs are used, respectively, 2 or 1 time per day.

Combined drugs B. s. usually represent a combination of representatives of two or all three of the above described groups, or a combination of B. s. with other (for example, antiallergic) agents. applied to each of the drugs in the combination are transferred to the entire combination. The most well-known combination drugs are listed below.

"Berodual" - a metered aerosol for inhalation containing a single dose (1) of fenoterol hydrobromide 50 mcg and Ipratorium bromide 20 mcg. It is used for relief and for the prevention of bronchospasm.

"Bronholitin" - syrup, 125 ml of which contains ephedrine hydrochloride 0.1 G and glaucine hydrochloride (an antitussive) 0.125 G, as well as sage oil and (0.125 G).

"Ditek" - a metered aerosol for inhalation, containing in a single dose 50 mcg fenoterol hydrobromide and 1 mg disodium cromoglycate, which prevents the release of allergic mediators. Used for bronchial asthma.

"Combivent" - a metered aerosol for inhalation, containing 120 mg in a single dose mcg salbutamol sulfate and 20 mcg Ipratorium bromide. It is used for relief and for the prevention of bronchospasm.

"Solutan" is a water-alcohol solution of several substances that have a bronchodilator and expectorant effect. IN 1 ml contain, in particular, ephedrine hydrochloride 1.75 mg, radobelina (Belladonna alkaloid) 0.1 mg, as well as sodium iodide (0.1 G), dill oil, saponin, novocaine, bitter almond. It is applied inside (adults - from 10 to 30 drops after meals up to 3 times a day). Contraindicated in glaucoma and sensitization to any of the ingredients.

"Teo-Astakhalin", as well as its forms forte and CR (prolonged action) - tablets containing salbutamol, respectively 2, 4 and 4 mg theophylline, respectively, 100, 200 and 300 mg.

"Teofedrin N" - tablets containing ephedrine (0.02 G), theophylline (0.1 G), caffeine (0.05 G), belladonna (0.003 G), cytisine (0.0001 G), phenobarbital (0.02 G), paracetamol (0.2 G). With the exception of theobromine and the replacement of phenacetin and amidopyrine with paracetamol, it differs from the previous drug "Teofedrin". It is used for bronchospasm of any origin. Adults are prescribed 1/2 tablet 1-3 times a day. Contraindicated in arterial hypertension, angina pectoris, extrasystole, tachycardia, glaucoma.

"Efatin" - a metered aerosol for inhalation, containing 0.1 ml(1 breath) 0.5 mg ephedrine hydrochloride and 0.2 mg atropine sulfate, as well as novocaine (0.4 mg). Used to stop bronchospasm in adults (1-3 doses per inhalation). It has the same contraindications as Teofedrin-N.

Currently, there are sufficient grounds to assert that the increased deaths are due, for the most part, not to suffocation itself, but to fatal heart rhythm disorders due to an overdose of adrenomimetics (or their combination with theophylline or with cardiac glycosides, unjustifiably administered "in connection with tachycardia"). Accordingly known comparative characteristics B. s. supplemented by another - the risk of cardiac death. Such a risk can be assessed as high not only for non-selective adrenomimetics, but also for fenoterol (in New Zealand, this drug in 1989 G . was banned for use in patients with bronchial asthma), and for theophylline. However, the very fact of a lower risk of death from the use of non-selective adrenomimetics orally (ephedrine) and by injection (adrenaline) half a century ago, i.e. with a deliberate calculation of the bronchodilator effect as part of the general adrenergic action, suggests that the study of such a risk cannot be limited to the area of only the properties of a particular drug (or a specific group of B. s.) without taking into account the influence of the method of its application, which for adrenomimetic B. s. became mostly inhaled. It is this method of direct, in essence, application of an adrenergic agonist to bronchial β 2 -adrenergic receptors that significantly accelerates the development of tachyphylaxis, which is natural for the use of any means of mediator action - loss of sensitivity of the receptor to its agonists, especially if the period between inhalations becomes less than necessary for complete restoration of receptor function after excitation. Increasing in degree (up to the “blockade” of receptors) with increased inhalation, it significantly changes the picture of the underlying disease (with bronchial asthma, the outline and frequency of attacks characteristic of it practically disappear), and makes its course heavier. continued use of adrenergic agonists leads to their overdose with generalization of adrenergic effects, stimulation of cardiac functions and an increase in the body's need for oxygen if it cannot be satisfied in conditions of unresolved ventilation insufficiency, which is supplemented by the phenomenon of "shunting" of non-arterialized blood due to excitation of adrenergic receptors in the blood vessels of the respiratory tract and lungs, including numerous arteriovenous anastomoses here. between consumption and provision of tissues with oxygen - the main reason for the instability of cell membranes and the acute development of cardiac arrhythmias with the next administration of an adrenomimetic or theophylline preparations (total arrhythmogenic effect). For theophylline, the likelihood of overdose has increased with the use of prolonged forms. the pronounced individual variability in the metabolism and elimination of theophylline when used in these forms is supplemented by one more uncertainty: the expected uniformity of absorption of these drugs is not actually achieved in all cases. Accordingly, the adequacy of dosing, even if individual sensitivity to the drug is neglected, is difficult and requires, at a minimum, direct monitoring of theophylline concentration in the blood.

In the light of the above, it can be expected that in the coming years the tactics of using B. s. should be reviewed primarily in terms of the priority of therapy safety. From these positions, when discussing individual elements of the tactics of using B. s. a number of provisions should be highlighted.

1. Indication for B.'s use. is not bronchial obstruction in general, but only bronchospasm involved in its pathogenesis. It has the greatest value in a simple attack of bronchial asthma, less, but still significant - in a protracted one, however, with an attack duration of more than 2 h the probability of a sufficient effect from the use of B. s. is significantly reduced. In patients with chronic bronchitis, the leading role of bronchospasm can always be assumed when it occurs in response to pungent odors, a change in the temperature of the inhaled air, and other forms of respiratory irritation (reflex bronchospasm). In such cases, B. s. can be used both for relief and for the prevention of seizures. On the mechanisms of obstruction associated with allergic or infectious inflammation in the walls of the bronchi (congestion, edema, cells, bronchial glands), as well as with bronchosclerosis, B. s. do not work. therefore, in the case of the predominance of these mechanisms, B.'s use of s. contraindicated; the only exception may be a trial administration of theophylline for allergic inflammation.

2. The choice of a drug for long-term use cannot be carried out only on the basis of the results of a comparative study of the influence of different B. s. on the indicators of bronchial patency in this patient, even if the duration of the effect of the compared drugs and its “price” are determined simultaneously by the reaction of the cardiovascular system (pulse rate, blood pressure). Such an approach, giving the impression of the scientific validity of "individual selection of the drug", can become falsely orienting, especially for patients with chronic bronchitis. The latter are distinguished by a pronounced dynamism of the ratio of obstruction mechanisms on different days (according to the figurative characteristic of obstructive dyspnea by B.E. Votchalom - “it doesn’t happen day after day”). Accordingly, "tomorrow" may be forced to repeatedly and often inhale the recommended drug, not achieving the effect that "yesterday" was achieved with just one inhalation. In similar cases it is more rational, probably, alternation of different B. with. (and in different dosage forms) and the use of their individually selected combinations, incl. combinations with drugs of other groups (for example, anti-allergic), which requires additional work with the patient, teaching him to subjectively determine options for various states of suffocation, and with insufficient success, immediately consult a doctor.

For a single relief of bronchospasm, any B. s can be used, but with reflex bronchospasm, atrovent (ipratorium bromide) is preferable, with a protracted attack of bronchial asthma, eufillin. For periodic use (for the purpose of relief and prevention of bronchospasm), from the standpoint of the safety of therapy, atrovent, which has practically no undesirable consequences of use, should be the first to be tried; the second - theophylline (in various forms) and only then salbutamol and others. If atrovent is effective, but not completely, then the second drug may be berodual, however, the sufficiency of the effect of the latter should be in such a single dose that, when it is doubled, does not cause a reaction in the pulse and blood pressure.

3. method of introducing B. s. does not matter only in cases of their rare use (1 time in several days). If necessary, daily (especially more than 1 time per day) use of B. s. from the group of adrenomimetics, non-inhalation methods should be preferred.

4. The frequency of B.'s use, especially in bronchial asthma, should not, apparently, exceed the frequency of asthma attacks that occur. At the same time, it is advisable to use inhalation of adrenomimetics no more than 2 times a week, using, if necessary, non-inhalation methods of administering the same adrenomimetics or other B. s at intervals. and their combinations. on round-the-clock support of the bronchodilator effect seems to be incorrect, not only because of the very rare actual need for this, but also because multiple use during the day or the use of prolonged forms of B. s. practically cannot but lead to tachyphylaxis and the most likely consequence of this is an overdose of B. s. With an increase in seizures due to an exacerbation of the disease, their prevention should be carried out using not B. s., but anti-allergic, anti-inflammatory (up to a short use of inhaled glucocorticoids) and other means of treating the underlying disease. - I Adrenomimetic drugs (adrenomimetica; adreno [Receptors] + Greek mimētikos imitating, reproducing; syn. adrenomimetics) drugs that reproduce the effects of stimulation of adrenoceptors by their natural endogenous ... ... Medical Encyclopedia

I Antispasmodics (spasmolytica; Greek spasmos cramp, spasm + lytikos releasing, relieving) drugs that lower the tone and motor activity of smooth muscles and are used to prevent or eliminate spasms ... Medical Encyclopedia

I Expectorants (expectorantia) drugs that facilitate the secretion of sputum from the respiratory tract, mainly by reducing its viscosity. Distinguish O. with. reflex and direct action. To O.'s group with. reflex ... ... Medical Encyclopedia

- (antispasmodics), lek. in va, causing a decrease in tone or elimination of spasm of vascular smooth muscles and ext. organs (gastrointestinal tract, bronchi, uterus, biliary and urinary tract, etc.). Spasmolytic. they possess you ... ... Chemical Encyclopedia

I Bronchitis (bronchitis; bronchus [and] (Bronchi) + itis) inflammation of the bronchi. There are acute bronchitis, acute bronchiolitis (primarily inflammation of the distal parts of the bronchial tree of bronchioles) and chronic bronchitis, characterized by diffuse ... ... Medical Encyclopedia

I Pneumonia (pneumonia; Greek pneumon lung) is an infectious inflammation of the lung tissue that affects all structures of the lungs with the obligatory involvement of the alveoli. Non-infectious inflammatory processes in the lung tissue that occur under the influence of harmful ... ... Medical encyclopedia - (cholin [Receptors] + English to block block, delay; synonyms: anticholinergics, anticholinergics) drugs that eliminate the effects of acetylcholine and substances with a cholinomimetic effect due to the blockade of cholinergic receptors. IN… … Medical Encyclopedia

I Cough (tussis) is a reflex act characterized by a rare increase in intrathoracic pressure due to synchronous tension of the respiratory and accessory muscles with a closed glottis, followed by its opening and jerky ... ... Medical Encyclopedia

DYSPNEA- - violation of the frequency, rhythm or depth of breathing, accompanied, as a rule, by a feeling of lack of air. It may be associated with a violation in any link of the act of breathing, in which the cerebral cortex, respiratory center, spinal ... ... Encyclopedic Dictionary of Psychology and Pedagogy