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Bronchodilator agent. Does m-cholinergic receptors of the smooth muscle of the tracheobronchial tree (mainly at the level of large and medium bronchi) and inhibits reflex bronchoconstriction. Having structural similarity to acetylcholine molecule, it is a competitive antagonist. It effectively prevents the narrowing of the bronchi, resulting from the inhalation of cigarette smoke, cold air, the effect of different substances bronhospazmiruyuschih and inhibits bronchospasm associated with the influence of the vagus nerves. Inhalation application has almost no resorptive action, while only 10% reach the alveoli and small bronchi, and the remainder is deposited in the mouth or pharynx and swallowed.

In patients with bronchospasm associated with chronic obstructive pulmonary disease (chronic bronchitis and emphysema), improves lung function: forced expiratory volume in the first second (FEV1) and the mean forced expiratory volume rate of 25-75% increased by 15% or more within 15 minutes after administration, the maximum effect observed after 1-2 hours, and most patients continued until 6 hours.

In patients with asthma a significant improvement of the external breathing function observed in 40% of patients (FEV1 increased by 15% or more).

Pharmacokinetics
Absorption – low. Displayed through the intestines.
Poorly soluble in fat and slightly penetrate through biological membranes.
In the digestive tract practically not absorbed and excreted in the feces. Suck part of the (small) is metabolized in 8 inactive or weakly active anticholinergic metabolites (excreted by the kidneys). Not accumulates.

Indications
Chronic obstructive pulmonary disease (chronic obstructive bronchitis, emphysema); asthma (moderate and mild).

Contraindications
: Hypersensitivity to atropine and its derivatives; hypersensitivity to ipratropium primobolan depot for sale or other components of the drug; . pregnancy (I term) Precautions – closure glaucoma, urinary tract obstruction, prostatic hyperplasia; breast-feeding, child age (up to 6 years).

Pregnancy and lactation
Atrovent Safety during pregnancy in humans has not been established. In appointing the drug during a possible or confirmed pregnancy should take into account the ratio of the expected benefits from the appointment of the drug and the possible risk to the fetus.

The data on the penetration of Atrovent in breast milk are not available. However, since many drugs are excreted in breast milk, it should be used with caution Atrovent women during lactation.

Dosage and administration
(20 drops = about 1 ml, 1 drop = 0.0125 mg ipratropium primobolan depot for sale anhydrous)
Dosage regimen is adjusted individually. During treatment, patients should be under medical supervision. If your doctor is not indicated differently, we recommend the following dosing regimen:

Maintenance treatment:

Adults (including the elderly) and children over 12 years of age:
2.0 ml (40 drops = 0.5 mg) 3-4 times a day.
The maximum daily dose – 8.0 ml (2 mg).

Children 6 to 12 years:
Treatment should be under medical supervision;
1.0 ml (20 drops = 0.25 mg) 3-4 times a day.
The maximum daily dose – 4 ml (1 mg).

Children under 6 years:
Treatment should be under medical supervision,
according to 0.4-1.0 mL (8-20 drops = 0.1-0.25 mg) 3-4 times a day.
The maximum daily dose – 4 ml ( 1 mg).

Acute bronchospasm: Adults (including elderly) and children over 12 years of age: 2.0 ml (40 drops = 0.5 mg); the possibility of reappointment to stabilize the patient’s condition. The interval between puffs is determined by your doctor.

Atrovent may be used in conjunction with inhaled beta2-agonists.

Children 6 to 12 years:
Treatment should be under medical supervision.
1.0 ml (20 drops = 0.25 mg); the possibility of reappointment to stabilize the patient’s condition. The interval between puffs is determined by your doctor.

Atrovent may be used in conjunction with inhaled beta2- agonists.

Children under 6 years:
. Treatment should be under medical supervision
0.4-1.0 mL (8-20 drops = 0.1-0.25 mg); the possibility of reappointment to stabilize the patient’s condition. The interval between puffs is determined by your doctor. Atrovent may be used in conjunction with inhaled beta2- agonists.

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

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

Atrovent inhalation solution can be applied using a variety of nebulizers available on the market. By using a centralized oxygen system solution is best applied at a flow rate of 6-8 liters per minute.

Side effects

The most common adverse side effects are dry mouth, headache, disturbance of motility of the gastrointestinal tract (constipation, diarrhea, nausea, vomiting).

Such undesirable side effects such as an increase in heart rate, supraventricular tachycardia, atrial fibrillation, palpitations, disturbance of accommodation, urinary retention are rare and are reversible. In patients with obstructive lesions of the urinary tract increases the risk of urinary retention.

There are some reports of the occurrence of complications in the eye (such as mydriasis, paresis of accommodation, increased intraocular pressure, particularly in patients with narrow-angle glaucoma, eye pain) when the product enters the eye.

Eye pain or discomfort, blurry vision, ghosting and color spots before the eyes, combined with conjunctival and corneal hyperemia may be symptoms of an attack angle-closure glaucoma. In the event of any of these symptoms, you should assign the drops that cause constriction of the pupil and immediately contact an ophthalmologist.

As with other inhalation therapy, including bronchodilators, sometimes there is a cough, local irritation, sometimes paradoxical bronchospasm.

There are reports of allergic reactions, including skin rash (erythema multiforme, urticaria), swelling of the tongue, lips and face, spasm of the larynx, laryngospasm and anaphylactic reactions.

Overdose
No specific overdose symptoms have been identified. Given the breadth of therapeutic action, and how to use local Atrovent ® , the emergence of any serious anticholinergic symptoms are unlikely. There are minor manifestations of systemic anticholinergic effects such as dry mouth, paresis of accommodation, increased heart rate. Treatment is symptomatic.

Interactions with other drugs
beta2-adrenergic agents and xanthine derivatives may enhance the bronchodilatory effect of the drug.

Anticholinergic effect is enhanced antiparkinsonian means, quinidine, tricyclic antidepressants. At simultaneous application with other anticholinergic drugs – additive effect.

When using Atrovent solution for inhalation in conjunction with inhaled beta-agonists in patients with angle-closure glaucoma, increased risk of developing an acute attack of glaucoma.

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

Cautions
Not recommended for emergency relief of an attack of breathlessness (bronchodilator effect develops later than that of beta-agonists).
Patients with cystic fibrosis have a higher likelihood of developing slow motility of the gastrointestinal tract.
It is recommended to avoid significant excess of recommended doses, as in the treatment of acute bronchospasm, so and supportive care.
If inhalation are not effective enough, or the patient’s condition has deteriorated, you should consult your doctor to change the treatment plan.
Atrovent inhalation solution can be used for combined inhaled simultaneously with Mukosolvanom solution for inhalation, Bizolvonom solution for inhalation and berotek solution for inhalation .
The product contains (antibacterial) preservative benzalkonium chloride and disodium edetate stabilizer, which can cause bronchoconstriction.
Patients must be able to correctly apply Atrovent solution for inhalation. Do not allow contact with eyes solution. Patients predisposed to the development of glaucoma, it should be warned about the need to protect the eyes from contact with the drug.
For inhalation nebulizer is recommended with a tip to the mouth. If you use a nebulizer with a mask, use the appropriate size mask. online anabolic steroids pharmacy

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