Atrovent - instructions for use, analogs, reviews and release forms (aerosol for inhalation of H and a solution, spray) for the treatment of bronchial asthma and chronic bronchitis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Atrovent. Comments of visitors of the site - consumers of this medication, as well as opinions of specialists in the use of Atrovent in their practice are presented. A big request is to actively add your feedback about a non-hormonal drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Atrovent in the presence of existing structural analogs.Use for the treatment of bronchial asthma and chronic bronchitis in adults, children, as well as in pregnancy and lactation. Composition of the preparation.

Atrovent - a bronchodilator. It blocks m-holinoretseptory smooth muscle tracheobronchial tree (mainly at the level of large and medium bronchi) and suppresses reflex bronchoconstriction. Having a structural similarity with the molecule of acetylcholine, it is its competitive antagonist.

It prevents bronchospasm arising from the inhalation of cigarette smoke, cold air, the effects of various drugs, and also eliminates bronchospasm associated with the influence of the vagus nerve.

When inhaled, it has almost no resorptive effect, with only 10% reaching the small bronchi and alveoli, and the remaining part settles in the pharynx or oral cavity and is swallowed.

In patients with bronchospasm associated with COPD (chronic bronchitis and emphysema), the drug improves the performance of external respiration function: FEV1 and the average volumetric rate of forced expiration of FEF25-75% increase by 15% or more after 15 minutes after drug administration.The maximum effect is achieved in 1-2 hours and continues in most patients up to 6 hours after the administration of ipratropium bromide.

In 40% of patients with bronchial asthma, there was a significant improvement in external respiration rates (FEV1 increased by 15% or more).

Composition

Ipratropium bromide monohydrate + excipients.

Pharmacokinetics

Absorption of the drug is low. Virtually not absorbed from the digestive tract. Poorly soluble in fats and weakly penetrates through biological membranes. Do not cumulate. The absorbed (small) part is metabolized with the formation of 8 inactive or weakly active metabolites, which have an anticholinergic effect. In unchanged form is excreted through the intestine. Metabolites are excreted in the urine.

Indications

• chronic obstructive pulmonary disease (including chronic obstructive bronchitis, emphysema);
• bronchial asthma of mild and moderate severity.

Forms of release

Aerosol for inhalation dosed Atrovent H (sometimes mistakenly referred to as a spray).

Solution for inhalation.

There is no dosage form in the form of tablets or capsules.

Instructions for use and dosage

Spray

The dosage regimen is set individually.

Adults and children over 6 years of age are prescribed 2 inhalation doses 4 times a day.

Given the lack of complete information, Atrovent H in children should be used only as directed by a doctor and under the supervision of adults.

The need to increase the dose may indicate the need to review the main treatment. The total daily dose is no more than 12 inhalations.

To treat exacerbation of chronic obstructive pulmonary diseases, Atrovent solution for inhalation can be used.

Terms of use

Before using the metered aerosol for the first time, you must press the valve twice to form an aerosol cloud.

Each time using a metered aerosol, the following rules must be observed:

1. Remove the protective cap.
2. Make a slow, deep exhalation.
3. Holding the balloon, grasp the tip with your lips. The cylinder should be pointed upside down.
4. While making the deepest inhalation, simultaneously quickly press the bottom of the cylinder until the first inhalation dose is released. Hold breath for a few seconds, then remove the tip from the mouth and slowly exhale. Repeat the procedure to obtain the 2nd inhalation dose.
5. Put the protective cap on.
6. If the aerosol can has not been used for more than 3 days, the valve should be pressed once before the aerosol cloud appears before use.

The cylinder is designed for 200 inhalations. Then the cylinder should be replaced. Despite the fact that some contents may remain in the container, the amount of drug released by inhalation decreases.

The balloon is opaque, so the amount of the drug in the bottle can be determined as follows: removing the protective cap, the balloon is immersed in a container filled with water. The amount of the preparation is determined depending on the position of the cylinder in the water.

The tip should be kept clean, if necessary, it can be rinsed in warm water. After using soap or detergent, the tip should be thoroughly rinsed with water.

The plastic tip is intended only for use with the metered aerosol Atrovent H and serves for accurate dosing of the preparation. The tip should not be used with other dosed aerosols. You can not also use metered aerosol Atrovent H with other tips.

Solution

It should be noted that 20 drops = 1 ml, 1 drop = 12.5 μg ipratropium bromide anhydrous.

Dosing regimen is selected individually. During treatment, patients should be under medical supervision.

For maintenance treatment, adults (including elderly patients) and children over 12 years of age are prescribed 2 ml (40 drops = 500 μg) 3-4 times a day. The maximum daily dose is 8 ml (2 mg).

Treatment of children should be carried out under medical supervision.

Children aged 6 to 12 years are prescribed 1 ml (20 drops = 250 μg) 3-4 times a day. The maximum daily dose is 4 ml (1 mg).

Children under 6 years of age are prescribed 0.4-1 ml (8-20 drops = 100-250 μg) 3-4 times a day. The maximum daily dose is 4 ml (1 mg).

For treatment of acute bronchospasm, adults (including elderly patients) and children over 12 years of age are prescribed 2 ml (40 drops = 500 μg); repeated appointments are possible until the patient's condition is stabilized. The interval between the administrations is set individually by the attending physician. Possible simultaneous use of beta2-adrenomimetics.

Application rules

The recommended dose of the drug should be diluted with physiological solution until the volume of the drug is 3-4 ml, pour into a nebulizer and inhalation. The drug should be diluted with saline each time before use. The solution remaining after inhalation is poured.

Dosage may depend on the inhalation method and the type of nebulizer. The duration of inhalation can be controlled by the expenditure of diluted volume.

Atroent can be used with various nebulizers available for sale. When using a centralized oxygen system, the solution is best used at a flow rate of 6-8 l / min.

Side effect

• headache;
• dry mouth;
• disorders of motility of the digestive tract (nausea, vomiting, diarrhea, constipation);
• increased heart rate;
• supraventricular tachycardia;
• atrial fibrillation;
• palpitation;
• violation of accommodation;
• retention of urine;
• cough;
• local irritation;
• paradoxical bronchospasm;
• dilated pupil;
• paresis of accommodation;
• increased intraocular pressure (especially in patients with closed-angle glaucoma);
• pain in the eye;
• blurred vision;
• the appearance of a halo and color spots in front of the eyes;
• skin rash;
• hives;
• angioedema;
• itching;
• swelling of the tongue, lips and face;
• laryngospasm;
• anaphylactic reactions.

Contraindications

• 1 trimester of pregnancy (spray Atrovent H);
• increased sensitivity to atropine and its derivatives;
• hypersensitivity to ipratropium bromide and other components of the drug.

Application in pregnancy and lactation

Atrovent safety during pregnancy in humans is not established. When prescribing the drug during a possible or confirmed pregnancy, it is necessary to take into account the ratio of the intended use of the drug and the possible risk to the fetus.

Spray Atrovent H is contraindicated in the first trimester of pregnancy. The appointment of the drug in the 2nd and 3rd trimester of pregnancy is possible only if the intended benefit of therapy for the mother exceeds the possible risk to the fetus.

Data on the penetration of Atrovent into breast milk are absent. However, given that many drugs are excreted in breast milk, care should be taken to prescribe Atrovent to women during lactation.

Use in children

Prescribe with caution in children under 6 years of age.

special instructions

It is not recommended to prescribe a drug for emergency relief of an attack of bronchial asthma (because the bronchodilator effect develops later than in beta-adrenomimetics).

In patients with cystic fibrosis, the risk of developing a slowing of the gastrointestinal motility is increased.

It is not recommended to allow a significant excess of recommended doses, both in the treatment of acute bronchospasm, and with maintenance treatment. The patient should be informed that if inhalations are not effective or if the condition worsens, you should consult your doctor to change the treatment plan.

Atroent can be used for combined inhalations simultaneously with Ambroxol (inhalation solution), Bromhexine (inhalation solution) and Berotek (inhalation solution).

The drug contains an antibacterial preservative benzalkonium chloride and a disodium edetate stabilizer, which can cause a narrowing of the lumen of the bronchi (the risk of developing bronchospasm).

The drug is released by prescription.

The patient should be trained in the correct use of the Atrovent.

Do not allow solution to enter the eyes. Patients who are predisposed to the development of glaucoma should be especially warned about the need to protect the eyes from getting the drug.

In case of appearance of any symptom of an angle-closure glaucoma attack (eye pain, discomfort, blurred vision, appearance of a halo and color spots in front of the eyes in combination with conjunctival and corneal hyperemia),appoint drops that cause a narrowing of the pupil, and immediately consult an ophthalmologist.

For inhalations it is recommended to use nebulizers with a tip for the mouth. When using a nebulizer with a mask, a mask of the appropriate size should be used.

Drug Interactions

With the simultaneous use of beta2-adrenomimetics and xanthine derivatives potentiate the bronchodilator effect of Atrovent.

With the simultaneous use of Atrovent with antiparkinsonian means, quinidine, tricyclic antidepressants, the anticholinergic effect of the drug increases.

With the simultaneous use of Atrovent with other anticholinergic drugs, an additive effect is noted.

With the simultaneous use of Atrovent with inhaled beta2-adrenomimetics in patients with angle-closure glaucoma, the risk of developing an acute attack of glaucoma increases.

Atrovent should not be administered concomitantly with the inhalation solution of disodium cromoglycate, given the possibility of precipitation.

Analogues of drug Atrovent

Structural analogs for the active substance:

• Atrovent H;
• Ipravent;
• Ipratropium Steri-Neb;
• Ipratropium bromide monohydrate.

Analogues on the curative effect (funds for the treatment of bronchial asthma):

• Ironyl;
• Alvesco;
• Aminophylline;
• Asthmopent;
• Afonilum;
• Beklazone;
• Beclomethasone;
• Benacorte;
• Berlikort;
• Berodual;
• Berodualal H;
• Berotek;
• Berotek H;
• Betamethasone;
• Bronchalamine;
• Budesonide;
• Ventolin;
• Hydrocortisone;
• Histaglobin;
• Glycyrs;
• Decortin;
• Dexamethasone;
• Josette;
• Diprospan;
• Zaditen;
• Intal;
• Ipladol;
• Ithral;
• KromoGexal;
• Cromogen;
• Montelar;
• Oxys Turbuhaler;
• Platyphylline;
• Polyoxidonium;
• Polcortolone;
• Prednisolone;
• Pulmicort Turbuhaler;
• Rengalin;
• Salbutamol;
• Seredid Multidisk;
• Symbicort Turbuhaler;
• Solutan;
• Theotard;
• Triamcinolone;
• Foradyl;
• Foradil Combi;
• Fortecortin;
• Celeston;
• Eladon;
• Erbisol;
• Erdomed;
• Erespal;
• Eufillin;
• Eufilong.

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