In the treatment of bronchial asthma, together with beta-adrenergic agonists, inhaled glucocorticosteroids are widely used, which reduce the frequency and severity of bronchospasm attacks. Among this group of medicines, “Budenite” for inhalation is worth highlighting. Instructions for the use of "Budenitis" contains comprehensive information on the use of the drug, so we will pay attention to the consideration of its key features and technical nuances of the application when conducting nebulizer therapy.
The composition of the tool "Budenite Steri-Neb" (suspension)
The instruction says that the drug is a suspension for inhalation, devoid of color and odor, packed in 2 ml polyethylene ampoules containing 1 mg (0.5 mg / ml) or 0.5 mg (0.25 mg / ml) active substance budesonide. This substance belongs to the pharmacological group of glucocorticoid hormones for topical use.
Pharmacodynamics
As indicated by the instruction “Budenite” for inhalation, budesonide (the main active ingredient) has an anti-allergic, anti-inflammatory and anti-edematous effect. By stimulating the production of lipocortin protein, budesonide has a depressing effect on the synthesis of phospholipase, which, in turn, leads to a decrease in the synthesis of arachidonic acid, a decrease in the production of prostaglandins and leukotrienes. These processes at the cellular level lead to a decrease in the production of cytokines, reduce the migration of macrophages and lead to a decrease in cellular infiltration. Ultimately, this leads to a decrease in the level of inflammatory mediators, which positively affects the relief of asthma attacks and the stabilization of its clinical course.
As the instructions for use indicate the Budenite Steri-Neb drug, its regular use leads to the restoration of the sensitivity of the bronchial tree to drugs that expand the bronchi. This, in turn, reduces the frequency of application of the latter, reduces the amount of formed bronchial secretion of sputum, reduces sensitivity to allergens, which also has a positive effect on the clinical course of the disease.
The drug does not have mineralocorticoid activity, and also does not have a systemic effect due to local action, which reduces the frequency and severity of side effects, is well tolerated with prolonged use.
As the instructions for use indicate the Budenite Steri-Neb drug, the analogues of this drug are also well tolerated and do not cause side effects associated with the use of systemic glucocorticosteroids.
After a single application, the therapeutic effect develops after a few hours, reaching maximum severity 1-2 weeks after the start of use. The drug can be effectively used to prevent the occurrence of bronchial asthma of physical stress, however, due to the long latent period of the onset of therapeutic action, it is practically not suitable for the relief of acute conditions accompanied by bronchospasm.
Pharmacokinetics
The drug is administered using a nebulizer. After inhaling the fine aerosol, budesonide settles on the surface of the bronchial tree. About 15% of the drug due to absorption in the lumen of the bronchial tree enters the systemic circulation and is then metabolized using a system of cytochromes to almost inactive metabolites (their activity is 100 times less than the activity of the starting substance). About 70% of the drug is excreted by the kidneys, another 10% is excreted through the intestines.
Indications for use
As a basic drug, budesonide and its analogues are indicated for the treatment and prevention of asthma attacks, the ineffective use of selective beta-adrenergic agonists to prevent the onset of the disease and stabilize the clinical picture, as well as to reduce the therapeutic dose of oral glucocorticoid drugs. The drug has been successfully used to treat stenosing laryngotracheitis and chronic obstructive pulmonary disease.
Contraindications
“Budenite Steri-Neb” (suspension for inhalation) is contraindicated in the presence of allergic reactions to one or more of the components that make up the drug, as well as children under the age of 6 years. With great caution, the drug is prescribed for pulmonary tuberculosis, damage to the respiratory system of viral, bacterial, fungal microflora, impaired liver function. The ban on the use of the drug in the presence of infectious diseases is due to the local immunosuppressive effect on the mucosa, which may lead to a decrease in the immune response and the progression of the disease.
Side effects
Due to the fact that the drug is administered by inhalation using a nebulizer, there is a high probability of dryness of the mucous membrane of the oral cavity and upper respiratory tract, a sensation of sore throat and irritation, unusual and unpleasant taste sensations, hoarseness or hoarseness of the voice, cough. This is due to the subsidence of the microparticles of the drug on the surface of the mucosa.
Quite rarely, there are disturbances in the activity of the nervous system, which manifest themselves in the form of nervousness and increased neuropsychic irritability, behavioral disturbances, and headaches. In addition, patients using Budenite sometimes notice the occurrence of allergic reactions in the form of urticaria, itching or redness of the skin, spasm of the smooth muscles of the bronchial tree, as well as the development of candidiasis of the oral cavity and esophagus.
The onset of paradoxical bronchospasm and progressive dyspnea after the start of the first dose inhalation is due to the irritating effect of the drug on the mucous membrane of the respiratory tract. With the development of this side effect, it is recommended to stop inhalation and prescribe alternative therapy.
Despite the low bioavailability of the drug and its predominantly local effect, with prolonged use, the development of systemic effects of glucocorticosteroids is possible. This is manifested by inhibition of the adrenal cortex, a slowdown in growth in children, a decrease in bone mineral density, and development of visual impairment.
In some cases (very rarely), skin irritation may occur when using a nebulizer mask. In order to prevent this complication, it is necessary to use disinfectant solutions for the mask, and after inhalation, rinse your skin with running warm water. You can also loosen the gum holding the mask on your face. A good alternative is to use a mouthpiece or mouthpiece for inhalation.
Use during pregnancy and lactation
The instruction for Budenit recommends prescribing the drug with caution in pregnant women, as well as during breastfeeding (although there are no data on the ingestion of the drug in mother’s milk). The drug is recommended to be used only if its benefit to the mother exceeds the possible negative consequences and complications for the fetus. In this case, budesonide should be used in a minimally effective dosage, which allows full control over the course of the disease.
Drug interactions
At the level of pharmaceutical interaction, the drug is fully compatible with isotonic sodium chloride solution, as well as other inhaled beta-adrenergic agonists, mucolytics and expectorant drugs. In order to increase the effectiveness of treatment and therapeutic effect when stopping bronchial spasm, preparations of these groups can be placed together in a nebulizer chamber. The joint use of bronchodilators not only improves the entry of Budesonide into the bronchoalveolar tree, but also contributes to its deeper penetration through the lumen.
Due to the participation of enzymes of the cytochrome P450 group in the metabolism of budesonide, the dose of the drug should be reviewed when using drugs that inhibit or stimulate the activity of this enzyme. The combined use of the drug with antifungal drugs such as Ketoconazole and Intraconazole is not recommended, as this can lead to an increase in the concentration of Budesonide in the plasma.
Medicines that increase the activity of microsomal enzymes (Phenobarbital, Phenytoin, Rifampicin), reduce the activity of Budesonide.
Mode of application
It is quite simple to use Budenit for inhalation. Instructions for use indicate the need for a nebulizer for therapy. The drug is placed in the nebulizer chamber of the device, and inhalation is performed. The duration of inhalation and dosage should be selected in each case, taking into account the clinical condition and severity of the patient's disease when using the drug "Budenite" for inhalation. Instructions for children from 6 months to 12 years indicate the appointment of budesonide in half the dosage. For patients over 12 years of age, the maintenance dose should be selected individually.
If necessary, the combination of "Budenitis" with oral glucocorticoid drugs is recommended to increase the dose of "Budenitis" in order to prevent the occurrence and reduce the severity of side effects.
Reviews
The attending physicians and patients are satisfied with the effectiveness of the drug. This is evidenced by each review of the (suspension for inhalation Teva "Budenite" - a fairly popular medication) drug. A positive attitude to it is formed by a low incidence of side effects and high treatment effectiveness. Opinions about the drug “Budenite” for inhalation for children (instructions, dosage are given in the article) are positive for mothers, which is also due to the low incidence of side effects. The painless inhalation using nebulizers (which can be made in the form of various toys) in young children also speaks in favor of using this drug or its analogues.
Overdose
In acute overdose of the drug, no pronounced clinical symptoms are observed. The treatment is symptomatic, with the withdrawal of the drug and the appointment of short-acting bronchodilators.
It should be borne in mind that with prolonged use of "Budenitis" in doses exceeding the average therapeutic, it is possible to develop side effects at the system level (hypercorticism, inhibition of adrenal function). This is evidenced by the drug "Budenite" for inhalation instructions. Its price is affordable for prolonged use of this drug as the main one for the treatment of bronchial asthma.
Separate directions and recommendations
Instructions for use of the drug "Budenite" suggests that it is not intended to relieve an acute attack of bronchospasm. The average time for the development of a therapeutic effect is about 10 days, but it can be increased if there is a large amount of mucus or viscous secretion in the lumen of the bronchial tree. In this case, it is possible to carry out treatment in combination with oral glucocorticoids with the subsequent transition only to Budyonite Steri-Neb for inhalation.
The instruction for the drug says that although the likelihood of side effects at the system level is much lower, it is imperative that the minimum effective therapeutic dose be titrated to obtain the maximum effect. When using the drug in children in order to timely detect the development of side effects, the growth of the child over a long period of time should be constantly monitored. With the development of side effects, the dose should be reduced to the least effective, which allows you to control attacks of bronchial asthma.
To prevent the occurrence of a fungal infection in the oral cavity, the patient should be informed about the need to rinse the oral cavity and remove the remnants of the drug after each inhalation. This helps to restore local immunity of the oral cavity and mucous membranes.
Technical features of use
Inhalation of "Budenitis" using ultrasonic nebulizers is contraindicated. The effective dose of the drug should be calculated taking into account the technical features of a particular nebulizer (taking into account the speed of the air flow, the volume of the nebulizer chamber, etc.) and the patient's condition.
Before using the drug "Budenite" for inhalation in a nebulizer, the instructions for a nebulizer must be studied. This will avoid improper connection of the device and inefficient use of the drug. If the nebulizer is used for the first time, it is recommended to test it using a physiological solution of sodium chloride, make sure that it is working, and then use it with medicines.
Before inhalation, a plastic ampoule is removed from the box, opened by tearing the cap, the drug is placed in the nebulizer chamber of the device, a mask is put on the face (or the mouthpiece is clamped), and the air stream is applied. When carrying out inhalations with the help of a mouthpiece, it is necessary to breathe only through the mouth (a special clip is put on the nose). When using a breathing mask, the use of a nasal clip is optional.
For inhalation, it is recommended to use a nebulizer chamber with a valve device, which provides injection of a finely dispersed aerosol of the drug directly at the time of inhalation and closes the exit of the drug at the time of exhalation. This helps to increase the delivery of the drug to the bronchoalveolar tree and reduces the loss of the drug during exhalation.
“Budenit Steri-Neb”: analogues, price
Analogues of the medicine “Budyonite Steri-Neb” are such drugs as Pulmicort and Pulmicort Turbuhaler, Cortimen, Tafen, Budoster, Budenofalk and many others. For these medicines, as well as for the “Budenite” drug for inhalation, the instructions are identical due to the presence of the same active substance. The cost of these drugs depends on the pharmacy network and the region, as well as on the dosage. On average, the price ranges from 650 to 2550 rubles.
Conclusion
A highly effective drug for the treatment and prevention of asthma attacks is "Budenite" for inhalation. The instructions for the drug give comprehensive information about the dosage and conditions of use of this drug. Subject to the use of budesonide in accordance with the instructions and recommended dosages, the drug provides effective treatment. If for some reason you cannot purchase the original, there are analogues. "Budenit Steri-Neb" (price, instructions are now known to you) will save you from many diseases of the respiratory system.