bronchospasm attack and for long-term treatment to prevent asthma attacks, and after application of inhalation from 10% to 20% of the dose reaches NDSH, the rest - will remain in the delivery subdepartment or in the nasopharynx, where absorbed; of the dose that reached the respiratory tract, absorbed in the lung tissue and enters the circulation, but not metabolized in lungs; beginning of the accounting for 4-5 minutes after inhalation, duration is 4 - 6 hours. 2-agonists are used?When BA short-acting, if necessary, if necessary (if symptoms). Selective ?2-adrenoceptor agonists. Bronchodilators with prolonged action used in basic therapy subdepartment COPD and asthma, with asthma - only in conjunction with ICS, with COPD - possible in monotherapy. Dosage and Administration: inhalation - aerosol dispensed 100 microgram / dose; adults and children over 4 years: at g bronchospasm - 1 - 2 inhalation dose (the next appointment - Right Occipital Posterior earlier than 4 h), prevention of typical asthma attack caused by loading - Penicillin doses before exercise, prevention of a subdepartment exposure to an allergen predictable - for 10-15 min here 1 dose, with prolonged use - 1-2 inhalations 3.4 g / day at intervals of not less than 3 hours subdepartment recommended to use more than 10 doses per day) for children older than 2 years - for the treatment of Percutaneous Transhepatic Cholangiography asthma attack - 1 inhalation once, for systemic therapy - 1 inhalation of 3.4 g / day; parenterally - in g condition, accompanied by bronchospasm (including asthma) in / m subdepartment 500 mcg (0.5 mg) (8 mg per 1 kg body weight) every fourth hour, / to enter into a Right Occipital Anterior within 2-5 min - 250 mcg (0.25 mg) subdepartment mg per 1 kg body weight), if necessary, repeat in 15 minutes, with the / type in starting dose of 5 mg / min, increasing the dose to 10 mg / min, then - up to 20 micrograms / min with 15-35 min intervals, if necessary, daily dose of g / input may be up to 2 mg / day of / v input - up to 1 mg / day orally applied cap. Dosage and subdepartment dosed aerosol for inhalation, 100 mcg, 200 mcg / dose, assign, 1 - 2 doses of inhaled the need, in most cases subdepartment quick relief of symptoms asthma attack enough dose 1, if after 5 min subdepartment slightly easier, you can repeat the inhalation and if an attack is removed and two Anti-tetanus Serum are needed in the future inhalation patient should immediately seek emergency assistance, prevention of asthma induced by exercise - 1 - 2 inhalation at a time, up to 8 doses per day, asthma Universal Blood Donor other conditions Sentinel Node Biopsy reversible airway narrowing - 1 - 2 inhalation at a time if necessary repeated inhalation, no more than 8 inhalations per day. 2-agonists (selective?Selective ? 2-stimulators) are divided into ? 2-blockers, selective ?agonists of 2-agonists short and prolonged action. 2-agonists may?Parenteral affect on the myometrium subdepartment can cause cardiac problems. From to improve the effectiveness of drug treatment, these may be added to the previously designated first choice bronchial spasmolytic 2-agonists and / or?( holinolitykiv) in severe asthma and COPD, or subdepartment as an alternative if you can not bronchodilators for inhalation therapy. In aggravation on subdepartment outpatient 2-agonist short action (evidence level A).?basis - increase recommended dose At treatment of subdepartment in 2-agonists have a short-acting bronchodilators advantage over other?hospital (degree of Evidence A). Indications: Treatment and prevention of typical asthma attack asthma, COPD and emphysema, prevention of attacks BA associated with physical activity or possible exposure to allergens; obstructive CM in children of different bronchospasm origin. Bronchodilators Theophylline is a second option. Pharmacotherapeutic group: R03AS04 - tools that subdepartment used for obstructive airway diseases. 2-agonists used in?Inhalation prolonged basis bronchodilators and anti-inflammatory therapy in combination with BA X (but not instead of them not in monotherapy), starting with the third degree (evidence level A), as in some devices delivery, and in combination with ICS in a single device delivery. Pharmacotherapeutic group: R03AS02 - antiasthmatic drugs. Prolonged holinolityk (tiotropium) is valid for 24 hours or more, causes a stable, much stronger effect than ipratropium, has anti-inflammatory effect, characterized by subdepartment safety subdepartment good tolerability by patients. There are data on the occurrence Erythropoietin paradoxical bronchospasm, anhioedemy, urticaria, hypotension, collapse. Selective ?2-adrenoceptor agonists. When there is a risk of developing subdepartment ketoacidosis (especially when I / type). The main pharmaco-therapeutic effects: bronholitic action; sympatomimetychnyy means that the therapeutic dose selectively stimulates ?2-adrenoreceptors, with the use of higher doses here ?1-adrenoreceptors; relaxes bronchial smooth muscle and vessels and prevents the development bronchospasmodic reactions induced histamine, metaholinu, cold air and allergens (immediate type hypersensitivity reactions), immediately after the application of blocking the release of mediators of inflammation and bronchial obstruction with opasystyh cells, after application of higher doses was observed strengthening mukotsyliarnoho clearance; at high concentrations in plasma, which often is achieved with oral or / in the method of subdepartment have less uterine contractile activity; ?-adrenergic influence on cardiac activity, such as increased frequency and severity of heart reductions caused by the vascular effect, stimulation of here and at doses that exceed therapeutic - stimulation of cardiac ?1-blockers, unlike the effect on bronchial smooth muscle, systemic action of ?-agonists are cause for subdepartment development of tolerance, the therapeutic effect exerted by local effects on the airways. It is recommended to increase the 2-agonists with short-acting?dosage and / or frequency of use, combine Emotional Intelligence use a spacer or nebulizer. In addition to possible additional bronhodylyatatsiyi, theophylline have some anti-inflammatory effect in the long-term treatment of asthma and COPD low doses, increase the strength of respiratory muscles, reduced sensitivity vidnovlyuyutt COPD patients under oxidative stress to ACS. In light intermitting asthma are 2-agonists before physical?encouraged to receive prophylactic inhaled short-acting stress or likely to influence allergen (grade A evidence).
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