Pulmicort
All about Pulmicort
Pharmacology
Pharmacological action - glucocorticoid, anti, anti.
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Application of the substance Pulmicort
Inhalation: asthma, chronic obstructive pulmonary disease.
Inside: Crohn's disease involving the ileum and / or ascending colon (for induction of remission in mild and moderate forms).
Intranasal: seasonal and perennial allergic rhinitis.
Contraindications
Hypersensitivity to inhalation of use: the active form of pulmonary tuberculosis, fungal infections of the respiratory system, for oral administration: gastrointestinal infections (bacterial, fungal, amebic, virus), severe liver problems, child age, for intranasal use: fungal, bacterial and viral infections respiratory, pulmonary tuberculosis.
Restrictions apply
For oral use: tuberculosis, hypertension, diabetes, osteoporosis, peptic ulcer, glaucoma, cataract, family history for diabetes or glaucoma.
Application of pregnancy and breastfeeding
When pregnancy is possible only if the expected effect of therapy outweighs the potential risk to the fetus (adequate and strictly controlled studies on the use during pregnancy has not carried out). Children whose mothers during pregnancy received large doses of corticosteroids should be closely watched (possible hypoadrenalism). In women of childbearing age before therapy should be possible for the pregnancy and during treatment - used reliable methods of contraception. At the time of treatment should stop breast-feeding (not known whether budesonide in breast milk).
Side effects of substance Pulmicort
If inhaled: hoarseness, sore throat, dryness or irritation of the mouth or throat, cough, less often - candidiasis of the mucous membranes of the mouth, nausea, sore throat, paradoxical bronchospasm.
Ingestion
The nervous system and sensory organs: depression, euphoria, irritability, glaucoma, cataracts.
With the cardiovascular system and blood system (blood, hemostasis): increased blood pressure, increased risk of thrombosis, vasculitis (withdrawal syndrome after prolonged treatment).
From the digestive tract: epigastric pain, dyspepsia, duodenal ulcer, pancreatitis.
From the endocrine organs: Cushing's syndrome, including moon face, obesity, body, diabetes mellitus, impaired glucose tolerance, sodium retention with the formation of edema, hypokalemia, decreased function, or atrophy of the adrenal cortex, impaired the secretion of sex hormones (amenorrhea, hirsutism, impotence).
From the musculoskeletal system: muscle weakness, osteoporosis, aseptic necrosis of bone (the femoral head and shoulder).
For the skin: an allergic rash, red striae, petechiae, ecchymosis, steroid acne, impaired wound healing, contact dermatitis.
Other: increased risk of infectious diseases.
When intranasal application: burning, irritation of the nose, sneezing, kandidomikoz.
Interaction
Inhibitors of cytochrome P450 (including ketoconazole, erythromycin, cyclosporine) may slow the metabolism and enhance the glucocorticoid effect. Budesonide may exacerbate the effects of cardiac glycosides (due to potassium deficiency); saluretics may increase hypokalemia. Co-administration of cimetidine and budesonide can lead to a slight increase in plasma levels of budesonide (clinical significance has not). Omeprazole (with concomitant administration) has no effect on the pharmacokinetics of budesonide.
Overdose
Symptoms of chronic overdose: manifestations of hypercortisolism.
Treatment: removal of budesonide by gradually lowering the dose.
Dosing and Administration
Inhalation: a dose adjusted individually, taking into account the severity of the disease, a maintenance dose of tablets glucocorticoids; adults - 200-800 mg / day (up to 1600 mg / day) in divided doses, for children - depending on age.
Inside: no chewing (in violation of the act of swallowing can open the capsule and swallow all the granules), drinking plenty of fluids (a full glass of water) for 30 minutes before meals, 3 mg, 3 times a day (morning, noon and evening). The course of treatment - usually 8 weeks, as a rule, the effect appears within 2-4 weeks. Cancellation is carried out gradually.
Intranasal: dose and duration of treatment are selected individually, taking into account the severity of the disease, adults and children over 18 years of a single dose - 2-3 drops in each nostril, usually enough 2 single doses a day for the duration of the course - 10-14 days .
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