Berotek mortar for inhalations: instructions for use
Berotek is a medicinal product belonging to the group of selective β-2-adrenomimetics. The drug helps to relax the smooth muscles of the bronchi and vessels and thus prevents the development of bronchospasm.
Form of issue and composition
Solution for inhalation Berotek is available in bottles with a dropper capacity of 20 ml, 40 ml or 100 ml. The bottle with the instruction is placed in a cardboard package.
The main active substance of Beroteka is fenoterol hydrobromide. In 1 ml of the inhalation solution contains 1 mg of fenoterol hydrobromide.
Auxiliary components: benzalkonium chloride, edetate disodium dihydrate, hydrochloric acid, sodium chloride, distilled water.
Pharmacodynamics. Berotek stimulates β-2 adrenergic receptors, located mainly in the respiratory system. Fenoterol suspends the release of inflammatory mediators and allergies from mast cells, thereby preventing the development of bronchial obstruction. The drug prevents the development of bronchial spasm of various origin. It starts to act 5 minutes after inhalation. The maximum therapeutic effect is observed after 30-90 minutes, it lasts from 3 to 6 hours.
In addition to the respiratory tract, β-adrenergic receptors are present in the cardiac muscle. Accordingly, Berotek has an effect on the work of the cardiovascular system (when exceeding the recommended doses): increases the strength and heart rate, increases blood flow and peripheral circulation.
Fenoterol in high dosages also affects β-1 adrenergic receptors, due to which it enhances mucociliary transport, inhibits contractile activity of the uterus, reduces the potassium content in the blood plasma, and breaks the fat and carbohydrate metabolism.
Pharmacokinetics. After inhalation of the lower calving of the respiratory tract reaches 10% to 30% of fenoterol (depending on the inhalation device and the inhalation method). The rest of the sprayed active substance settles in the upper parts of the respiratory tract, is swallowed, falling into the digestive tract. Bioavailability of fenoterol is 18-19%.
Absorption from the surface of the respiratory tract takes place in two phases. During the first 11 minutes after inhalation, about 30% of the active substance is absorbed. In the next 2 hours, the remaining 70% of fenoterol slowly penetrate into the soft tissues. The maximum plasma concentration of the drug is noted as early as 15 minutes after inhalation. 40-55% of the active components bind to plasma proteins.
Splitting of fenoterol to sulfates and glucuronides occurs in the liver. After passing through all the stages of metabolism and providing a therapeutic effect, inactive metabolites are excreted with bile, kidney. Fenoterol hydrobromide in an unchanged form penetrates the placental barrier and into breast milk.
Indications for use
Indications for the appointment of Berotek are:
- relief of bronchospasm and an attack of asthma arising on the background of bronchial asthma;
- symptomatic therapy of bronchial asthma and other pathologies characterized by reversible narrowing of the respiratory tract (chronic obstructive bronchitis , chronic obstructive pulmonary disease, emphysema);
- prevention of asthmatic attacks that occur against the background of physical effort;
- the need to expand the bronchi before inhalation with other drugs (antibiotics, glucocorticosteroids, mucolytics);
- carrying out bronchodilation tests to determine the parameters of the function of external respiration.
Berotek is contraindicated for use in the presence of certain pathologies, among which:
- hypertrophic obstructive cardiomyopathy;
- uncompensated diabetes mellitus;
- aortic stenosis;
- heart defects;
- hypersensitivity or individual intolerance to one of the components of the drug.
Also Berotek can not be prescribed to pregnant women in the first trimester, women breastfeeding and children under 4 years.
Method of application and dosage
Inhalations are carried out with the help of a special device - a nebulizer. The recommended single dose of the drug is dissolved in physiological solution, bringing the volume to 3-4 ml. It is strictly forbidden to dilute the preparation with distilled water. The drug solution is prepared immediately before the inhalation. The time interval between inhalations should be 4 hours.
In accordance with pharmaceutical dosages: 1 ml of the solution contains 20 drops, in 1 drop - 50 μg of fenoterol hydrobromide. The recommended dose depends on the patient's age and indications.
Recommended dosages for adults (including the elderly) and children over 12 years of age:
- cupping an attack of bronchial asthma - 0.5 ml (10 drops of solution), in severe cases - from 1 to 1.25 ml (20-25 drops), in extremely severe cases under the supervision of a doctor - 2 ml;
- prevention of an asthma attack caused by physical stress - 0.5 ml (10 drops) to 4 times a day;
- symptomatic treatment of asthma and other pathologies with reversible narrowing of the airways - 0.5 ml (10 drops) 4 times a day.
Recommended dosages for children from 6 to 12 years (with a body weight of 22 to 36 kg):
- relief of an attack of bronchial asthma - from 0.25 to 0.5 ml (5-10 drops of solution), in severe cases - 1 ml (20 drops), in exceptionally severe cases under the supervision of a doctor - 1.5 ml (30 drops);
- prevention of an asthma attack caused by physical stress - 0.25-0.5 ml (5-10 drops) 4 times a day;
- symptomatic treatment of asthma and other pathologies with reversible narrowing of the airways - 0.25-0.5 ml (5-10 drops) 4 times a day.
Recommended dosages for children from 4 to 6 years (with body weight up to 22 kg):
- 1 drop (0.05 ml) per 1 kg of body weight, but not more than 10 drops (0.5 ml) of the solution for one dose; the frequency of reception is up to 3 times a day.
Treatment usually begins with the lowest recommended dose.
When using the solution for the inhalation of Berotek, unwanted side effects from various body systems can develop.
From the respiratory system:
- local irritation of mucous membranes;
- paradoxical bronchospasm (extremely rare).
From the cardiovascular system:
- increased heart rate;
- tachycardia ;
- increased systolic blood pressure;
- decreased diastolic blood pressure;
- anginal pain.
From the central nervous system:
- violation of accommodation (the ability to clearly see objects at different distances);
- small tremor;
On the part of the digestive system - nausea and vomiting.
From other organs and systems:
- hypokalemia - a decrease in the concentration of potassium ions in the blood (more often observed in patients with severe forms of bronchial asthma, taking glucocorticosteroids, diuretics, xanthines);
- hyperglycemia (increased blood glucose levels);
- Myalgia (muscle pain) and muscle spasms;
- retention of urination;
- increased sweating.
Allergic reactions - a rash, urticaria , angioedema, swelling of the lips, tongue, face.
When an overdose of the drug develops tachycardia, arrhythmia, palpitations, anginal pain and attack of angina, hypotension or hypertension (depending on the characteristics and predisposition of the body), intense reddening of the face and skin of the upper half of the body, small tremor. Specific antidotes to Beroteku are cardioselective β-adrenoblockers, especially β-1 receptor blockers. But the use of such drugs can strengthen bronchial obstruction, so the dosage of the antidote should be selected very carefully. Along with the use of antidotes, symptomatic treatment with sedatives and tranquilizers is carried out. The indications are intensive therapy.
Conservative treatment by Berotek under constant strict medical supervision is conducted for patients with the following pathologies:
- uncontrolled hypertension;
- severe heart and vascular disease;
- compensated form of diabetes mellitus;
- recently suffered myocardial infarction.
At appointment it is necessary to consider medicinal interaction with other preparations:
- the general therapeutic effect of Beroteka is enhanced with simultaneous use with anticholinergic substances, tricyclic antidepressants, β-adrenoreceptor agonists, monoamine oxidase (MAO) enzyme inhibitors;
- simultaneous application of Berotek with β-adrenomimetics, anticholinergics, xanthine derivatives (including theophylline) stimulates the development of side effects;
- the combination of Berotek with β-adrenoreceptor blockers leads to a marked decrease in bronchodilation (enlarged bronchial lumen);
- simultaneous reception with halogenated hydrocarbon antiseptics (enflurane, halothane and so on) enhances the effect of the active components of Berotek on the cardiovascular system.
The therapeutic effect of conservative treatment of bronchial asthma and chronic obstructive pulmonary disease with Berotek increases with its combined use with anti-inflammatory drugs (inhaled glucocorticosteroids). However, such treatment is recommended to be performed in a hospital for continuous monitoring of the patient's condition.
In cases of increased bronchial obstruction unacceptably uncontrolled excess of the prescribed dosages of Berotek and the duration of the recommended course - this can lead to worsening of the course of the disease.
The complete structural analogues of Berotek (preparations with the same active substance) are: Fenoterol-Nativ, Fenoterol Gidrobromide, Partusisten.
Terms and conditions of storage
The solution for inhalation Berotek is stored at a temperature of up to 30 ° C, in a dry place, protected from sunlight and inaccessible to children. Keep the drug away from open flame, do not freeze. Shelf life is 5 years. Do not use the medicinal product after the expiration date indicated on the package.
Berotek for inhalation price
Berotek solution for inhalation 0.1% 20ml - from 280 rubles.