Spiriwa

Roman name

Spiriva #

The composition and the form of

1 capsule powder inhalations tiotropia contains bromide monohydrate 22.5 g, which corresponds to 18 µ g tiotropia bromide; in the package 30 capsules complete with ingalatorom Handihaler.

Of drugs

Holinoliticescoe, bronhodilatirtee. Does various proved muskarinovykh receptors of M_1 M_5 before. The inhibition M_3-retseptorov in the respiratory passages is the relaxation of smooth muscles. The high affinity for receptor and slow dissociation from M_3-retseptorov make expressed, and a long bronhodilatirtee up at the local application in patients with chronic obstructive lung disease (COPD).

Pharmacokinetics

The inhalation of most ipratropia enters the stomach, and lower in the lungs. Absolute bioavailability in this kind of a 19.5%. Poor drawn from the blood, eating does not affect the removals. C_max after inhalation powder dose of 18 µ g is five mines, and is in patients with COPD from 17 to 19 pg / ml, equilibrium concentration in plasma -3-4 pg / ml. Linking blood plasma 72%, the volume of 32 l / kg It passes through Geb.biotransformation negligible, as evidenced by the fact that the on / in the preparation of healthy young volunteers in the urine detected 74% tiotropia unchanged. Tiotropy split nefermentative way to alcohol and N-metilskopina ditienilglikoleva acids, which do not involve the muskarinovmi receptor. Even excessive doses tiotropy not igibiruet zitohrom R450, 1A1, 1A2, 2V6, 2S9, 2S19, 2D6, 2A1 or 3A in mikrosomah liver Cheloveka.posle inhalation T_1/2 terminal is five to six days, displayed kidneys (14% of dose), the remainder (neabsorbirowawrzayasa in the gut) part from faeces.

Farmakodinamika

Bronhodilatiruty effect is the result of local, not systemic action depends on the dose and remained at least 24 hours The studies showed that the drug significantly increases the lung function (volume forced expiratory for 1), and vital capacity light after 30 minutes after a single dose for 24 hours Farmakodinamicescoe balance achieved in the first week and expressed bronhodilatiruty effect was observed on the third day. The drug increases the morning and evening peak expiratory flow, measured ill. The bronhodilatirutego effect for a year did not turn up for tolerance. The drug reduces the number of exacerbations increases up to the first increase in comparison with the placebo, as well as to improve the quality of life throughout the period of treatment, reduces the incidence of hospitalization related to the exacerbation of COPD and increases the time until first hospitalization.

Indications

As a maintenance therapy in patients with COPD, including chronic bronchitis and emphysema (with the continuing odyshke and to prevent attacks).

Pregnancy and lactation

Contraindicated in the first trimester of pregnancy. The remaining stages of pregnancy and breastfeeding only if the expected benefits exceed any potential risk to the foetus or infant.

Contraindications

Гиперчувствительност ь (incl. to atropino or its derivatives, for example, or ypratropiu oksitropiu), I trimester of pregnancy, children up to age 18.

Side-Effects

For part of the intestine : dry mouth (usually slightly symptoms often disappear for continuing treatment), Zapor.so the respiratory system : cough, local irritation may develop Bronhospazma.prochie : tachycardia, impede or delay urination (men with predraspolagatmi factors), angioneuroticeski swelling, blurred vision, severe glaucoma (related to antiholinergicakim act).

Specific guidance

The drug should not be used as a means of primary care in acute bronchospasm attacks (ie in urgent cases). After inhalation may develop Immediate reactions гиперчувствительност и.Не be allowed into powder Glaza.preparat should only apply to the device Handihaler.

Patient interaction

Not recommended simultaneous application with the other antiholinergicakimi means.

Precautions

Careful monitoring of patients with moderate or severe renal insufficiency receiving the drug in combination with other drugs, exretirutmisa, mainly Pockami.s caution appoint patients with glaucoma uzkougolna, giperplaziei prostate obstruction or neck bladder.

Dosing and Administration

Inhalation using the Handihaler, 1 kaps. per day at the same time. The drug should not be Glotati.pojilae people, patients with compromised function of the kidneys or liver may use drug in the recommended doses.

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