Seretid

Roman name

Seretide

Characteristics

Combined product.

Farmakodinamika

Серетид combined product contains салметерол and флутиказона пропионат that have different mechanisms of action. Salmeterol prevents the occurrence of bronchospasm, which flutikazon propionat improves lung function and prevents deterioration. Seretid can be an alternative for patients who are at the same time agonist бета_|2|-адренорецепто��ов and ingalaii �люкокортикостероид.С алметерол is a selective long-acting (up to 12 h) agonist beta_ | 2 | -adrainoretseptorov with long side chain, which binds to the outer domain �ецептора.Фармакологи ческие salmeterola properties offer protection against inductively gistaminom bronhokonstriktion and longer bronhodilatatia (not less than 12 hours) than agonists �ета_|2|-адренорецептор ов short-acting. The bronchodilator effect for 10-20 Min.salmeterol is a strong and long-acting inhibitor of the release of pulmonary tissue rights mediators fat cells, such as histamine, and lakotriena PGD_ | 2 |. Salmeterol oppressing early and late phase response to allergens 73.21; Last lasts more than 30 hours after the single-dose vaccination, or while bronhodilatiruty effect is not available. One introduction salmeterola weakens giperreaguosti Bronchus tree. This shows that in addition to salmeterol bronhorasshiratei activity had an additional effect, clinical importance has not been settled yet. The mechanism of action is different from противовоспалительно го effect �люкокортикостероидо��.В Therapeutic doses salmeterol no action on the cardiovascular Sistemu.flutikazon propionat belongs to the group �люкокортикостероидо�� for the local application and by inhalation in a recommended dose is expressed �ротивовоспалительно�� and protiwallergicescoe effect in the lungs, resulting in a reduction of clinical symptoms and reduce the frequency of exacerbations that as a result of obstruction respiratory tract. Restores reaction to the patient bronhodilatatora by helping to reduce the frequency of their use. The flutikazon propionata not accompanied by adverse events specific to the system глюкокортикостероидо в.При long-term use inhalation flutikazon propionata to the maximum recommended daily doses of hormones secretia crust napochechnikov remains within the limits of both the adults and children. After transferring patients receiving other glukokorticosteroida 73.21, to a reception flutikazon propionata daily secretia cortex hormones napochechnikov gradually improving, in spite of the previous and current use of the periodic oral steroids. This points to the restoration of napochechnikov against inhalation of flutikazon propionata. With long-term use flutikazon propionata backup function crust napochechnikov also remained within normal limits, as evidenced by the normal increase of cortisol in response to the stimulation (it must be borne in mind that lower residual adrenalovy reserve from the previous therapy may persist for a long time).

Indications

Basic therapy that as a result of reversible obstructive airways (including bronchial asthma in children and adults), it would be appropriate to the appointment of combination therapy : bronhodilatator and preparation of a group of inhalants глюкокортикостероидо в Patient :-receiving support effective dose agonists �ета-адренорецепторов �litelnogo actions and inhalants g люкокортикостероидов ;- �where there are symptoms in the face of therapy inhalants g люкокортикостероидам и;- �olucath regular treatment bronhodilatatormi requiring inhalation g люкокортикостероидах .Поддерживающая �erapia with chronic obstructive lung disease.

Pregnancy and lactation

Pregnant and lactating women appoint product only if the expected benefit to the mother than any possible risk to the fetus or child.

Contraindications

Hypersensitivity to the drug component, child age 4 Let.s caution-lung tuberculosis, fungal, viral or bacterial infection of the respiratory system, thyrotoxicosis and feohromotsytoma, diabetes, uncontrolled gipokaliemia, idiopathic gipertroficski subaortalny stenoses, uncontrolled blood pressure, arrhythmia, extended QT interval at elektrocardiogramme, ischemic heart disease, hypoxia different genesis, cataracts, glaucoma, hypothyroidism, osteoporosis, pregnancy, the period of breastfeeding.

Specific guidance

Treatment of asthma should be phased clinical monitoring patient response to treatment, and the lungs. The patient must be taught to use Ingalator.seretid not intended to alleviate the symptoms of acute because, in such cases, should be rapid and korotkoactuti ingalaii bronhodilatator (eg salbutamol). Patients should be informed that they have always been handy product for acute edema Simptomov.bolee frequent use of short bronhodilatatorov actions aimed at relieving symptoms indication of the deterioration of the disease, and in such situations, the patient must turn to Vrachu.vnezapnoe and the increasing deterioration of bronhospasticski syndrome poses a potential threat to human life, and in such situations, the patient will also need to see a doctor. It is possible that the doctor will appoint a higher dose глюкокортикостероидо в. If a dose Seretida does not provide adequate control of the disease, the patient has to go to a doctor, who may designate additional glukokorticosteroida while worsening due to infection, the Antibiotiki.iz-za risk of developing acute treatment Seretidom be drastically cut, drug dose should be reduced gradually under control Vraca.luboy ingalaii glukokorticosteroid can cause systemic effects, especially in long-term use at high 25dbd doses; , it should be noted, however, that the likelihood of such symptoms much lower than in the treatment of oral �люкокортикостероида��и. Possible systemic effects include oppression of napochechnikov, delayed growth in children and adolescents, reducing the mineral density of bone tissue, cataracts, and glaucoma. Having said that, dose inhalation glukokorticosteroida titrovti it to the minimum, which ensures the maintenance of an effective Controla.v emergency planning and situations likely to cause stress, it is always important to keep in mind the possibility of oppression napochechnikov and to be prepared to use глюкокортикостероидо в.При the mobile activities or surgical interventions to the extent napochechnikova �едостаточности.Реком ендуется to measure the growth of children who receive long-term inhalation therapy �люкокортикостероидо��.Некоторые patients may be more sensitive to the effects of inhaled glukokorticosteroidov than most Patientov.vvidu the oppression napochechnikov, patients transferred from oral �люкокортикостероидо�� on the unconditional therapy flutikazon propionatom, should be treated with great caution and regularly monitor their function napochechnikov crust. The transfer of patients from admission system глюкокортикостероидо в on the unconditional therapy may be allergic reactions (eg, allergic rhinitis, eczema), which previously suppressed system �люкокортикостероида��и. In such situations should be symptomatic treatment antihistamines drugs and / or products of the local, including глюкокортикостероида ми for the local Primenenia.posle to treat inhalation flutikazon propionatom glukokorticosteroida system should be lifted gradually, and the patients must have a special card to show the possible need for further introduction �люкокортикостероидо�� Stress Seetuationh.u patients with exacerbation of asthma gipoksiei there is a need to control the concentration of K ^ + in Plazme.vnutrennaa surface of the cylinder and valve without visible defects.

Patient interaction

It should avoid the use of selective and selective бета-адреноблокаторо�� except when they are critical patient because of the risk of Bronhospazma.v normal circumstances inhalation flutikazon propionata with low concentrations in the plasma as a result of intensive metabolism in the "first pass" and the high systemic clearance under the influence izofermenta CYP3A4 system zitohroma R450 in the gut and liver. This clinically significant interactions involving флутиказона пропионата маловероятны.Исследо��ание Drug interactions showed that ritonavir (GPCR inhibitor izoferment CYP3A4) may cause a sharp increase in the concentrations of flutikazon propionata plasma, resulting in significantly lower concentrations of whey Kortizola.esti reports of clinically significant drug interactions in patients who received both flutikazon propionat and ritonavir. The interactions cause such side effects as fatigue Kushinga and oppression napochechnikov functions. Having said that, should avoid simultaneous application flutikazon propionata and ritonavira unless the potential benefit to the patient outweighs the risk of systemic side effects глюкокортикостероидо в.Другие izofermenta inhibitors of CYP3A4 pitiful (erythromycin), and a slight (ketokonazol) increasing flutikazon propionata plasma, in which virtually no reduction of whey cortisol. Despite this, it is recommended to be careful while applying flutikazon propionata and strong CYP3A4 inhibitors (eg ketokonazola), as such combinations not ruled out the possibility of increasing the concentration flutikazon propionata in Plazme.proizvodona xantina, glukokorticosteroida dioretiki and increase the risk of developing gipokaliemii (especially in patients with exacerbation of asthma in hypoxia). MAO inhibitors and Tricyclic antidepressants increase the risk of side effects from the heart Sistema.sovmestim kromoglicieva with acid.

Overdosing

The objective and subjective symptoms of overdose salmeterola include tremor, headache and tachycardia. Antidotes are cardioselektivee beta-adrenoblokatora. Where it is necessary to eliminate the Seretid overdose within it salmeterola patient should appoint a replacement глюкокортикостероид.��нгаляция flutikazon doses propionata recommended above can cause temporary oppression �ипоталамо-гипофизарн о-надпочечниковой system. Typically, it does not require any emergency action because, in most cases, normal function надпочечников restored for a few дней.При prolonged inhalation excessive doses Серетида may be meaningful надпочечников oppression. In the literature there are few reports of acute adrenalovom krize that arises mainly in children receiving excessive doses Seretida for a long time (several months or years); Acute adrenalovy kriz gipoglikemiei is accompanied by sputannostew consciousness and / or convulsions. The situations that can serve as a trigger factors acute adrenalovy kriza include trauma, surgery, infection or rapid decline dose member of Seretida flutikazon Propionata.patienta should know that there should be no Seretid in doses above recommended. It is important to regularly evaluate the effectiveness of therapy and the reduction Серетида dose to the minimum effective, or so, which provides effective control of symptoms. In chronic overdose encouraged to control backup functions napochechnikov crust.

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