Proair Inhaler

Description

Proair Inhaler (albuterol sulfate) is a bronchodilator drug. Albuterol sulfate is a selective beta2-adrenergic agonist. In therapeutic doses, it acts on beta2-adrenergic receptors of the smooth muscles of the bronchi, providing a pronounced bronchodilator effect. It prevents and relieves bronchospasm and increases the vital capacity of the lungs. It also prevents the release of histamine, a slow-reacting substance from mast cells and neutrophil chemotaxis factors. Albuterol sulfate causes a slight positive chrono- and inotropic effect on the myocardium, dilation of the coronary arteries, and practically does not reduce blood pressure. It has a tocolytic effect: it lowers the tone and contractile activity of the myometrium. The action of the drug begins 5 minutes after inhalation and lasts for 4-6 hours.
Albuterol sulfate has a number of metabolic effects: it reduces the content of K in plasma, renders hyperglycemic (especially in patients with bronchial asthma) and lipolytic effect, increases the risk of acidosis.

Indication for use

• Prevention and relief of bronchospasm in bronchial asthma;
• Chronic obstructive pulmonary disease (COPD);
• Chronic bronchitis and emphysema.

Dosage and instructions for use

The medicine is intended for inhalation.

Adults and children over 12 years of age: 100-200 mcg of albuterol sulfate (1-2 inhalations) to relieve asthma attacks.

If the patient does not feel better after 5 minutes, inhalation may be repeated. Subsequent inhalation can be done no earlier than 2 hours later.

To control the course of mild asthma: 1-2 doses 1-4 times a day.

To control the course of asthma of moderate severity: 1-2 doses 1-4 times a day in combination with other anti-asthmatic drugs.

To prevent exercise enduced asthma: 1-2 inhalations 20-30 minutes before exercise.

Children aged 2-12 years: to relieve an attack of bronchial asthma, as well as to prevent attacks of bronchial asthma associated with exposure to an allergen or caused by physical activity: the recommended dose is 90-200 mcg (1-2 inhalations).

The daily dose of albuterol sulfate should not exceed 1200 mcg.

Contraindications

• Hypersensitivity to any component of the drug;
• Rhythm disturbances (paroxysmal tachycardia, polytopic ventricular extrasystole);
• Myocarditis;
• Heart defects;
• Aortic stenosis;
• Cardiac ischemia;
• Severe heart failure;
• Decompensated diabetes mellitus;
• Glaucoma;
• Epileptic seizures;
• Pyloroduodenal narrowing;
• Kidney or liver failure;
• Pregnancy;
• Co-administration with non-selective beta-blockers;
• Children’s age under 2 years.

Precautions

Proair Inhaler should be used with caution in patients with thyrotoxicosis, tachyarrhythmia, myocarditis, heart defects, aortic stenosis, coronary heart disease, severe chronic heart failure, arterial hypertension, pheochromocytoma, decompensated diabetes mellitus, glaucoma, as well as during pregnancy and during breastfeeding.

Side effects

• Frequent side effects: tremor, headache, tachycardia.
• Infrequent side effects: irritation of the mucous membrane of the oral cavity and pharynx, palpitations, muscle cramps.
• Rare side effects: hypokalemia (beta2-agonist therapy can lead to severe hypokalemia), peripheral vasodilation.
• Very rare side effects: hypersensitivity reactions, including urticaria, angioedema, bronchospasm, hypotension, collapse, paradoxical bronchospasm, hyperactivity, arrhythmia, including atrial fibrillation, supraventricular tachycardia and extrasystoles.

Drug interactions

It is not recommended to simultaneously use Proair Inhaler and non-selective β-adrenergic blockers, such as propranolol. Albuterol sulfate is not contraindicated in patients receiving monoamine oxidase inhibitors (MAOIs).

Overdose

Symptoms: Signs and symptoms of albuterol overdose are transient effects, pharmacologically due to stimulation of β-adrenergic receptors, such as lowering blood pressure, tachycardia, muscle tremor, nausea, vomiting, hyperglycemia, lactic acidosis.

The use of high doses of albuterol can cause hypokalemia, so it is necessary to control the concentration of potassium in the blood plasma.

Treatment: The inhalation should be discontinued. Appropriate symptomatic therapy is required. Cardioselective β-blockers in patients with cardiac symptoms (eg, tachycardia, palpitations) should be used with caution due to the risk of bronchospasm.

Pregnancy and breastfeeding

Proair Inhaler is contraindicated in case of a threatened miscarriage in the I and II trimesters of pregnancy, premature detachment of the placenta, bleeding or toxicosis in the III trimester of pregnancy.

If it is necessary to use albuterol inhalers during pregnancy, the expected benefit of treatment for the mother and the potential risk to the fetus should be correlated. Currently, there is insufficient data on the safety of albuterol in early pregnancy. Albuterol sulfate is excreted in breast milk, therefore, if it necessary to use the medicine during breastfeeding, one must also evaluate the expected benefits of treatment for the mother and the possible risk to the child.

Special instructions

In patients with severe or unstable asthma, the use of bronchodilators should not be the main or only method of therapy.

If the effect of the usual dose of Proair Inhaler becomes less effective or less prolonged (the effect of the drug should last at least 3 hours), the patient should consult a doctor.

Frequent use of albuterol sulfate can lead to increased bronchospasm, sudden death, and therefore, it is necessary to take breaks of several hours between taking regular doses of the drug.

An increased need for the use of inhaled beta2-adrenergic agonists with a short duration of action to control the symptoms of bronchial asthma indicates an exacerbation of the disease. In such cases, the patient’s treatment plan should be reviewed.