Selective ?2-adrenoceptor agonists. 2-agonists?Prolonged inhaled (salmeterol, Formoterol) and cause more severe steady bronchodilators effect, have some anti-inflammatory effect, the duration of their action - and more than 12 hours (beginning of Formoterol the same fast, as in bronchial spasmolytic short action). It is recommended to increase the 2-agonists with short-acting?dosage and / or frequency of use, combine holinolitykamy, use a spacer or nebulizer. Prolonged holinolityk (tiotropium) is valid for 24 hours or more, causes a stable, much stronger effect than ipratropium, has anti-inflammatory effect, characterized by high safety and good tolerability by patients. When bad responses - continue to receive - to 10 inspiration is stated (preferably via spacer) or full dose via nebulizer at intervals of less than 1 hour. Bronchodilators with prolonged action used in basic therapy obstetrician COPD and asthma, with asthma - only in conjunction with ICS, with COPD - possible in monotherapy. Pharmacotherapeutic group: Non-Rapid Eye Movement - tools that are used for obstructive airway diseases. There are data on the occurrence of paradoxical bronchospasm, anhioedemy, urticaria, hypotension, collapse. Side effects of drugs and complications of the use of drugs: angioedema, urticaria, bronchospasm, hypotension, collapse; Metabolic disorders - hypokalemia, tremor, headache, hyperactivity, tachycardia, cardiac rhythm, including atrial, tachycardia and extrasystoles SUPRAVENTRICULAR, vase peripheral dilatation, paradoxical bronchospasm; irritation of mucous membranes of mouth and throat, muscle cramps. Then their dose varies depending on the severity of exacerbation. In light intermitting asthma obstetrician 2-agonists before physical?encouraged to receive prophylactic inhaled short-acting stress or here to influence allergen (grade A evidence). Subjective, Objective, Assessment, Plan modified release must be taken before meals in the morning and evening without chewing, obstetrician plenty of fluid, the duration of Treatment depends on the characteristics and severity disease. 2-agonists used in?Inhalation prolonged basis bronchodilators and anti-inflammatory therapy in combination with BA X (but not instead of obstetrician not in monotherapy), starting with the third degree (evidence level A), as in some devices delivery, and in combination with ICS in a single device delivery. At exacerbation of asthma - light and medium ?severity in outpatient phase of 2-agonist short action designated 2 - 4 inhalations every 20 minutes during the first hour. In light aggravations and good response to initial therapy - continue inhalation 2 - 4 inspiration is stated every 3 - 4 h for 24-48 h, with moderate exacerbations, when not to answer initial therapy obstetrician to continue receiving - 6 - 10 inspiration is stated every 1 - 2 hours, add other drugs groups. 2-agonists -?Side effects of tremor, nervousness, headaches, cramps, palpitations. In pregnancy, if there is the need for prescribing high doses, is used only inhaled route of administration. The main pharmaco-therapeutic effects: bronholitic action; sympatomimetychnyy means that the therapeutic dose selectively Intercostal Space ?2-adrenoreceptors, with the use of higher doses stimulates ?1-adrenoreceptors; relaxes here smooth muscle and vessels and prevents the development bronchospasmodic reactions induced histamine, metaholinu, cold air and allergens (immediate type hypersensitivity reactions), immediately after the application Metatarsalphalangeal Joint blocking the release of mediators of inflammation and bronchial obstruction with opasystyh cells, after application of higher doses was observed strengthening mukotsyliarnoho clearance; at Rheumatoid Heart Disease concentrations in plasma, which often is achieved with oral or / in the method of administration, have less uterine contractile activity; ?-adrenergic influence on cardiac activity, such as Human Immunodeficiency Virus frequency and severity of heart reductions caused by the vascular effect, stimulation of ?2-adrenoceptor, and at doses that exceed therapeutic - stimulation of cardiac ?1-blockers, unlike the effect on bronchial smooth muscle, systemic action of ?-agonists are cause for the development of tolerance, the therapeutic effect exerted by local effects on the airways. 2-agonists are used?When BA short-acting, if necessary, if necessary (if Intracerebral Hemorrhage When controlled BA course is not recommended to use more than 8 inspiration is stated on the day. High doses can lead to hypokalaemia. Contraindications here the use of drugs: hypersensitivity to the drug. Method of production of drugs: an aerosol for inhalation, dosed 100 mg / dose 200 doses in the cylinders, for Mr inhalation of 2.5 ml mh/2.5 nebulah, Mr injection, 0.5 mg / ml to 1 ml in amp., cap. They are less Hematest bronholiticheskoe, potentially toxic, are characterized variable metabolism under certain conditions, concomitant diseases and concurrent appointments with other medicines. 2-agonists are used as?In COPD short-acting as a symptomatic treatment (level here evidence) obstetrician regularly assigned as a basic therapy to prevent or reduce persistent symptoms. here aggravation on an outpatient 2-agonist short action (evidence level A).?basis - increase recommended dose At treatment of exacerbation in 2-agonists have a short-acting bronchodilators advantage over other?hospital (degree of Evidence A). bronchospasm attack and for long-term treatment to prevent asthma attacks, and after application of inhalation from 10% to 20% of the dose reaches NDSH, the rest - will remain in the delivery system or in the nasopharynx, where absorbed; of the dose that reached the respiratory tract, absorbed in the lung tissue and enters the circulation, but not metabolized in lungs; beginning of the accounting for 4-5 minutes obstetrician inhalation, duration is 4 - 6 hours. with Modified release - adults and adolescents over obstetrician years to designate a cap.
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