In the treatment of bronchial asthma, along with beta-adrenergic agonists, inhaled glucocorticosteroids are widely used to reduce the frequency and severity of bronchospasm attacks. Among this group of drugs, it is worth highlighting "Budenit" for inhalation. Instructions for use "Budenit" contains comprehensive information on the use of the drug, so we will pay attention to the consideration of its key features and technical nuances of use during nebulizer therapy.
Composition of "Budenit Steri-Neb" (suspension)
The instruction says that the drug is a suspension for inhalation, devoid of color and odor, packed in 2 ml polyethylene ampoules containing 1 mg (0.5 mg / ml) or 0.5 mg (0. 25 mg / ml) of the active substance budesonide. This substancebelongs to the pharmacological group of glucocorticoid hormones for topical use.
Pharmacodynamics
As evidenced by the drug "Budenit" for inhalation instructions, budesonide (the main active ingredient) has an anti-allergic, anti-inflammatory and anti-edematous effect. By stimulating the production of lipocortin protein, budesonide has an inhibitory effect on the synthesis of phospholipase, which, in turn, leads to a decrease in the synthesis of arachidonic acid, a decrease in the production of prostaglandins and leukotrienes. These processes at the cellular level lead to a decrease in the production of cytokines, reduce the migration of macrophages and lead to a decrease in cellular infiltration. Ultimately, this leads to a decrease in the level of inflammatory mediators, which has a positive effect on the relief of asthma attacks and the stabilization of its clinical course.
As evidenced by the drug "Budenit Steri-Neb" instructions for use, its regular use leads to the restoration of the sensitivity of the bronchial tree to drugs that dilate the bronchi. This, in turn, reduces the frequency of use of the latter, reduces the amount of bronchial sputum secretion formed, reduces sensitivity to allergens, which also has a positive effect on the clinical course of the disease.
The drug does not have mineralocorticoid activity, and also does not have a systemic effect fordue to local action, which reduces the frequency and severity of side effects, is well tolerated with long-term use.
As evidenced by the drug "Budenit Steri-Neb" instructions for use, analogues of this drug are also well tolerated and do not cause side effects associated with the use of systemic glucocorticosteroids.
After a single application, the therapeutic effect develops after a few hours, reaching a maximum in 1-2 weeks after the start of use. The drug can be effectively used to prevent the occurrence of bronchial asthma of physical exertion, however, due to the long latent period of the onset of therapeutic action, it is practically not suitable for the relief of acute conditions accompanied by bronchospasm.
Pharmacokinetics
The drug is administered using a nebulizer. After inhalation of a fine aerosol, budesonide settles on the surface of the bronchial tree. About 15% of the drug, due to absorption in the lumen of the bronchial tree, enters the systemic circulation and is further metabolized using the cytochrome system to practically inactive metabolites (their activity is 100 times less than the activity of the parent substance). About 70% of the drug is excreted by the kidneys, another 10% is excreted through the intestines.
Indications for use
As a basic drug, budesonide and its analoguesare indicated for the treatment and prevention of asthma attacks, with the ineffectiveness of the use of selective beta-agonists to prevent the onset of the disease and stabilize the clinical picture, as well as to reduce the therapeutic dose of oral glucocorticoid agents. The drug is successfully used for the treatment of stenosing laryngotracheitis and chronic obstructive pulmonary disease.
Contraindications
"Budenit Steri-Neb" (suspension for inhalation) is contraindicated in the presence of allergic reactions to one or more components that make up the drug, as well as children under 6 years of age. With great care, the drug is prescribed for pulmonary tuberculosis, damage to the respiratory system by viral, bacterial, fungal microflora, impaired liver function. The ban on the use of the drug in the presence of infectious diseases is due to the local immunosuppressive effect on the mucous membrane, which can lead to a decrease in the immune response and progression of the disease.
Side effects
Due to the fact that the drug is administered by inhalation using a nebulizer, there is a high probability of dryness of the mucous membrane of the oral cavity and upper respiratory tract, a sensation of sore throat and irritation, unusual and unpleasant taste sensations, hoarseness or hoarseness, cough. This is due to the deposition of microparticles of the drug on the surface of the mucosa.
Quite rarely there are violations of activitynervous system, which manifest themselves in the form of nervousness and increased neuropsychic excitability, behavioral disorders, headache. In addition, patients using Budenit sometimes note the occurrence of allergic reactions in the form of urticaria, itching or redness of the skin, spasm of the smooth muscles of the bronchial tree, as well as the development of candidiasis of the oral cavity and esophagus.
The occurrence of paradoxical bronchospasm and progressive dyspnea after the start of inhalation of the first dose is due to the irritant effect of the drug on the respiratory mucosa. With the development of this side effect, it is recommended to stop inhalation and prescribe alternative therapy.
Despite the low bioavailability of the drug and its predominantly local effect, with prolonged use, systemic effects of glucocorticosteroids may develop. This is manifested by inhibition of the activity of the adrenal cortex, a slowdown in growth in children, a decrease in bone mineral density, and the development of visual impairment.
In some cases (very rarely), facial skin irritation may occur when using a nebulizer mask. In order to prevent this complication, it is necessary to use disinfectant solutions for the mask, and after inhalation, rinse the skin of the face with running warm water. You can also loosen the elastic band that holds the mask to your face. A good alternative is to use a mouthpiece or mouthpiece for inhalation.
Use during pregnancy and lactation
Instruction for "Budenit" recommends to prescribe the drug with caution in pregnant women, as well as during breastfeeding (although there is no data on the drug getting into mother's milk). The drug is recommended to be used only when its benefit to the mother outweighs the possible negative consequences and complications for the fetus. In this case, budesonide should be used in the minimum effective dosage that allows you to fully control the course of the disease.
Drug Interactions
At the level of pharmaceutical interaction, the drug is fully compatible with isotonic sodium chloride solution, as well as other inhaled beta-agonists, mucolytics and expectorants. In order to increase the effectiveness of treatment and therapeutic effect in the relief of bronchial spasm, drugs of these groups can be placed together in the nebulizer chamber. The combined use of bronchodilators not only improves the flow of "Budesonide" into the bronchoalveolar tree, but also contributes to its deeper penetration through the lumen.
Due to the involvement of enzymes of the cytochrome P450 group in the metabolism of budesonide, the dose of the drug should be reviewed when using drugs that inhibit or stimulate the activity of this enzyme. The combined use of the drug with antifungal drugs such as Ketoconazole and Intraconazole is not recommended, as this may lead to an increase in the concentration"Budesonide" in plasma.
Drugs that increase the activity of microsomal enzymes (Phenobarbital, Phenytoin, Rifampicin) reduce the activity of Budesonide.
How to use
It's pretty easy to use "Budenit" for inhalation. Instructions for use indicates the need to use a nebulizer for therapy. The drug is placed in the nebulizer chamber of the device, and inhalation is performed. The duration of inhalation and dosage should be selected in each case, taking into account the clinical condition and severity of the patient's disease when using Budenit for inhalation. The instruction for children from 6 months to 12 years indicates the appointment of budesonide at half the dosage. For patients over 12 years of age, the maintenance dose should be adjusted individually.
If it is necessary to combine "Budenit" with oral glucocorticoid drugs, it is recommended to increase the dose of "Budenit" in order to prevent the occurrence and reduce the severity of side effects.
Reviews
Training physicians and patients are satisfied with the effectiveness of the drug. This is evidenced by every review of the (Teva "Budenit" suspension for inhalation is a fairly popular medication) drug. A positive attitude towards it is formed by the low incidence of side effects and the high effectiveness of treatment. Opinions about the drug "Budenit" for inhalation for children (instruction, dosage are given in the article) in mothers are positive, which is also due to the low incidence ofside effects. Painless inhalation with nebulizers (which can be made in the form of various toys) in young children also supports the use of this drug or its analogues.
Overdose
In case of acute overdose of the drug, no pronounced clinical symptoms are observed. Treatment is symptomatic, with drug withdrawal and short-acting bronchodilators.
It should be borne in mind that with prolonged use of "Budenit" in doses exceeding the average therapeutic, side effects may develop at the system level (hypercorticism, suppression of adrenal function). This is evidenced by the drug "Budenit" for inhalation instructions. Its price is affordable for long-term use of this drug as the main treatment for bronchial asthma.
Special instructions and recommendations
Instructions for the use of the drug "Budenit" says that it is not intended to relieve an acute attack of bronchospasm. The average time for the development of a therapeutic effect is about 10 days, but it can be increased if there is a large amount of mucus or viscous secretion in the lumen of the bronchial tree. In this case, it is possible to carry out treatment in combination with oral glucocorticoids, followed by a transition only to "Budenit Steri-Neb" for inhalation.
The instructions for the drug say that althoughthe likelihood of side effects at the systemic level is much lower, it is imperative to titrate the minimum effective therapeutic dose to obtain the maximum effect. When using the drug in children, in order to timely detect the development of side effects, the growth of the child should be constantly monitored over a long period of time. With the development of side effects, the dose should be reduced to the least effective, which allows you to control asthma attacks.
To prevent the occurrence of a fungal infection in the oral cavity, the patient should be informed about the need to rinse the mouth and remove the remnants of the drug after each inhalation. This helps to restore local immunity of the oral cavity and mucous membranes.
Technical features of use
Inhalation of "Budenit" with the help of ultrasonic nebulizers is contraindicated. The effective dose of the drug should be calculated taking into account the technical features of a particular nebulizer (taking into account the air flow rate, the volume of the nebulizer chamber, etc.) and the condition of the patient.
Before using the drug "Budenit" for inhalation in a nebulizer, the instruction of the nebulizer must be studied without fail. This will avoid incorrect connection of the device and ineffective use of the drug. If the nebulizer is used for the first time, it is recommended to test it with saline sodium chloride solution to make sure ithe alth and then use with drugs.
Before inhalation, a plastic ampoule is removed from the box, opened by tearing off the cap, the drug is placed in the nebulizer chamber of the device, a mask is put on the face (or the mouthpiece is clamped) and the air flow is supplied. When carrying out inhalations using a mouthpiece, it is necessary to breathe only through the mouth (a special clip is put on the nose). When using a breathing mask, the use of a nose clip is optional.
For inhalation, it is recommended to use a nebulizer chamber with a valve device that injects a fine aerosol of the drug directly at the moment of inhalation and closes the drug outlet at the moment of exhalation. This helps to increase drug delivery to the bronchoalveolar tree and reduces drug loss during exhalation.
"Budenitis Steri-Neb": analogues, price
Analogues of the drug "Budenit Steri-Neb" are drugs such as "Pulmicort" and "Pulmicort Turbuhaler", "Cortimen", "Tafen", "Budoster", "Budenofalk" and many others. For these medicines, as well as for the drug "Budenit" for inhalation, the instructions are identical due to the presence of the same active substance. The cost of these drugs depends on the pharmacy chain and region, as well as on the dosage. On average, the price ranges from 650 to 2550 rubles.
Conclusion
Highly effective drug for the treatment and prevention of bronchial attacksasthma is "Budenitis" for inhalation. The instruction to the drug gives comprehensive information about the dosage and conditions for the use of this drug. Provided that budesonide is used in accordance with the instructions and recommended dosages, the drug provides effective treatment. If for some reason you cannot purchase the original, there are analogues. "Budenitis Steri-Neb" (price, instructions you now know) will save you from many diseases of the respiratory system.
