The diagnosis of “bronchial asthma” or other disease with airway obstruction with symptoms of shortness of breath and asthma attacks involves the use of the drug Salmeterol . Bronchodilator restores the patency of the bronchial tree and the passage of atmospheric air into the lungs. As a result, the patient’s quality of life improves, mental and physical performance increases.
Indications for use
The main and main indication for the use of Salmeterol is bronchial asthma. The drug can be prescribed as monotherapy for intermittent or mild persistent bronchial asthma, as well as in combination with other bronchodilators , glucocorticosteroids , cromones and vitamin complexes for moderate and severe persistent asthma.
Salmeterol in combination is also taken with special clinical and pathogenetic forms of asthma: reflux-induced, occupational, nocturnal, physical effort. In this case, the dose is selected taking into account the frequency of seizures and peak flow measurements .
The severe course of chronic bronchitis with an asthmatic component is an indication for the appointment of Salmeterol , when there is no way to stop the attack with other drugs. Reasonably, Salmeterol is prescribed to patients with chronic obstructive pulmonary disease on the background of occupational factors, genetic predisposition and abuse of tobacco smoking .
Salmeterol is absolutely contraindicated for use in case of individual intolerance to the active ingredient, a history of immediate reaction (urticaria, angioedema, anaphylactic shock). In pediatric practice, it is not recommended for children under 4 years of age.
The dose is adjusted personally and the dynamics are monitored for patients with cardiovascular pathologies: arrhythmia, ischemic heart disease, hypertension with frequent attacks of hypertensive crisis.
Salmeterol is used with caution in endocrinopathies (thyrotoxicosis, thyrotoxic crisis, pheochromocytoma ) due to changes in the parameters of the potassium ion in the blood, since its decrease is observed.
The instructions for use allow the use of Salmeterol when carrying a child, however, it is prescribed if the expected therapeutic effect for the mother is much higher than the possible fetopathies . For elderly and senile patients, the average therapeutic dose is determined.
Mechanism of action
The peculiarity of the mechanism of action of Salmeterol is the ability to selectively affect the receptors of the mucous membrane of the bronchial tree. It acts as an agonist of β2-adrenergic receptors, which implies the interaction of a chemical compound with a receptor and a change in the state of biological tissue.
Pharmacodynamics of the drug Salmeterol :
- expansion of the lumen of the bronchioles, improved air permeability;
- increased gas exchange in the lungs;
- decreased reactivity – production of viscous mucus and sputum;
- blocking the synthesis of inflammatory mediators (prostaglandins, leukotrienes and other cytokines);
- decrease in the intensity of primary and secondary responses to inhalation triggers.
Vasodilation occurs 4-9 minutes after using Salmeterol , the peak effect is 3-4 hours, the duration of the drug action is 10-12 hours.
Regular use of the drug provides lasting results with a decrease in the frequency of night and day attacks of suffocation.
- quickly absorbed through the bronchial mucosa;
- enters the general bloodstream;
- the active substance is evenly distributed in the blood plasma;
- metabolized by the liver parenchyma (the half-life depends on the functioning of the organ, normally it is 7-8 hours);
- metabolites with bile enter the intestine;
- excreted with feces.
Composition of the preparation
The group belonging of the drug Salmeterol is beta- adrenomimetics . The main component is salmeterol xinafoate – a white or slightly yellow powder.
The international trade name is Salmeterol , it is a suspension of the smallest particles. It carried out the issue of salmeterol in a metered aerosol form for inhalation.
Salmeterol is not available in solid (tablets), liquid (solution), and soft (ointment) forms.
The dosage depends on the clinical picture and the severity of the underlying disease, the dose for adults and children over 12 years old is twice as high as for children from 4 to 12 years old.
Salmeterol belongs to basic therapy and is not suitable for status asthmaticus as an emergency aid.
Algorithm for using the bronchodilator Salmeterol for inhalation:
- Remove the protective cap.
- Shake the medicine bottle well.
- The balloon is placed upside down.
- Exhale deeply.
- Cover the mouthpiece tightly with your lips.
- A deep breath is started while pressing the bottom of the balloon, hold the breath for 1-3 seconds and exhale slowly after removing the mouthpiece from the mouth.
- The protective cap is put on the balloon, and the mouthpiece is thoroughly rinsed in warm water. Do not put a metal container in water.
- Avoid eye contact with aerosol particles.
After the measures taken, rinsing the mouth is allowed to remove residual particles.
Complete analogues of Salmeterol in composition: Airtrek , Serevent Evohaler , Serobid , Flutisal .
Brief description of mono-component analogs:
- Serevent Evohaler is a French manufacturer’s anti-asthma drug.
- Serobid is a selective beta-2-adrenergic receptor agonist produced in India.
Brief description of combined analogs:
- Airtrak is available in the form of an aerosol, it contains an additional ingredient – fluticasone . Pharmaceutical manufacturer – India.
- Salmerix consists of salmeterol and fluticasone and is produced in Poland.
- Seretide Discus ( salmeterol and fluticasone ) in a foil blister with placed cells, available in the UK.
- Flutisal is a combined agent ( salmeterol and fluticasone ) from an Indian manufacturer.
Most often, adverse reactions are recorded in the form of increased heart rate, headaches and tremors of the limbs. This reaction is due to the presence of extrapulmonary beta- adrenergic receptors , which are affected by the main substance salmeterol .
- heart rhythm disturbance (extrasystole, supraventricular tachycardia) against a background of increased heart rate;
- isolated increase in blood pressure when systolic blood pressure is above 140 mm Hg. Art., and diastolic blood pressure below 90 mm Hg. Art .;
- irritation of the oral mucosa, the appearance of microcracks, ulceration;
- nausea, vomiting, moderate pain in the umbilical region;
- perversion of taste, addiction to unusual products;
- dizziness, weakness, malaise, sleep disturbance;
- local reactions due to irritation of the nasal mucosa and throat with small particles of the salmeterol component (rhinitis, laryngitis);
- joint pain;
- a decrease in the indicators of potassium ions in the blood;
- individual intolerance with the development of an allergic reaction.
In some cases, there may be an increase in cough or the development of paradoxical bronchospasm after inhalation . In this case, an urgent cancellation of Salmeterol is needed , consultation of the attending physician and pulmonologist. Self-correction of the daily and single dose of the bronchodilator Salmeterol is not recommended.