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ბეროდუალი / Berodual | მედიკამენტები | vidal.ge

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შემადგენლობა
ხსნარი ინჰალაციისთვის: ფლაკონში 20 მლ.
1 მლ. შეიცავს 500 მკგ ფენოტეროლის ჰიდრობრომიდს და 250 მკგ იპრატროპიუმის ბრომიდს.

ფარმაკოლოგიური მოქმედება
ბეროდუალი წარმოადგენს კომბინირებულ ბრონქოლიზურ საშუალებას, რომლის შემადგენლობაში შემავალ კომპონენტებს გააჩნიათ მოქმედების სხვადასხვა მექანიზმი და ლოკალიზაცია. ფენოტეროლის (ბეტა2 -ადრენომიმეტური) მოქმედების მექანიზმი დაკავშირებულია ადენილატციკლაზას აქტივობასთან, რაც იწვევს ციკლური ადენოზინმონოფოსფატის წარმოქმნის გაძლიერებას, რომელიც ასტიმულირებს კალციუმის ტუმბოს მუშაობას, რის შედეგადაც მიოფიბრილებში მცირდება კალციუმის კონცენტრაცია და ადგილი აქვს ბრონქების დილატაციას. ხსნის ან ამცირებს ბრონქოსპაზმს, რომელიც დაკავშირებულია ცთომილი ნერვის ზეგავლენასთან, ამცირებს ჯირკვლების სეკრეციას (მათ შორის ბრონქიალურს).
ზემოთაღნიშნული ნივთიერებების კომბინაცია აძლიერებს ბრონქოლიზურ მოქმედებას და ზრდის მის ხანგრძლივობას, რაც იძლევა ბეტა-ადრენომიმეტური პრეპარატის დოზის მნიშვნელოვანი დაქვეითების შესაძლებლობას და არსებითად ამცირებს ამ უკანასკნელის მოქმედების შედეგად გამოწვეულ გვერდით მოვლენებს.

ფარმაკოკინეტიკა
პრეპარატის აქტიური კომპონენტების მაქსიმალური კონცენტრაცია სისხლის პლაზმაში აღინიშნება ინჰალაციის შემდეგ.
საინჰალაციო გზით შეყვანის შემდეგ სისხლის პლაზმაში არსებული მისი კონცენტრაცია 500-1000-ჯერ ნაკლებია, ვიდრე პერორალურად მიღების შემდეგ. პრეპარატის მოქმედების დასაწყისი საინჰალაციო გზით მისი გამოყენებისას ექვივალენტურ დოზებში აღინიშნება უფრო სწრაფად.

ჩვენება
- ფილტვების ქრონიკული ობსტრუქციული დაავადებების ბაზისური მკურნალობა;
- ბრონქული ასთმის შედეგად გამოწვეული სულის ხუთვის მწვავე შეტევის პროფილაქტიკა და მკურნალობა;
- ქრონიკული ობსტრუქციული ბრონქიტი ემფიზემით ან მის გარეშე.
- ბრონქოობსტრუქციული სინდრომით მიმდინარე დაავადებების და ბრონქების მომატებული მგრძნობელობისას, სუნთქვის უკმარისობის პროფილაქტიკისა და შემანარჩუნებელი თერაპიისათვის.
- სასუნთქი გზების მომზადება სამკურნალო საშუალებების (მუკოლიზური საშუალებები, კორტიკოსტეროიდები, ანტიბიოტიკები) საინჰალაციო გზით შესაყვანად.
დოზირებისა და მიღების რეჟიმი 3 წლის ასაკის ზევით ბავშვებსა და მოზრდილებში ბეროდუალი დოზირებული აეროზოლის სახით ინიშნება 3-ჯერ დღეში 1-2 დოზის (დღე-ღამეში 8/დოზამდე) ოდენობით. ბრონქული ასთმის შეტევისას გამოიყენება აეროზოლის 2 დოზა, აუცილებლობის შემთხვევაში 5 წუთის შემდეგ დამატებით კიდევ 2 დოზა, მომდევნო ინჰალაცია ტარდება 2 საათის შემდეგ.
საინჰალაციო ხსნარის რეკომენდებული თერაპიული დოზა შეადგენს 3-6-ჯერ დღეში 20-30 წვეთის (1-4 მლ) ოდენობით არანაკლებ 2 სთ-ის ინტერვალით. ნებულაიზერის გამოყენების შემთხვევაში საჭიროა პრეპარატის 20 წვეთი გავხსნათ 3 მლ ფიზიოლოგიურ ხსნარში და შევისუნთქოთ 5-7 წთ-ის განმავლობაში. ხსნარი უნდა გამოვიყენოთ მთლიანად.
6 წლამდე ასაკის ბავშვებში საინჰალაციო ხსნარის თერაპიული დოზა შეადგენს 0.05 მლ-ს (1 წვეთ/კგ-ზე 3-ჯერ დღეში და მიიღება ექიმის მეთვალყურეობის ქვეშ.
6-დან 14 წლამდე ასაკის ბავშვებში პრეპარატი ინიშნება 4-ჯერ დღეში 0.5-დან 1 მლ-ის (10-20 წვეთი) ოდენობით. მძიმე ფორმის შეტევების დროს შესაძლებელია 2-3 მლ-ის (40-60 წვეთის) მიღება ექიმის მეთვალყურეობის ქვეშ.

გვერდითი მოვლენები
გვერდითი მოვლენების განვითარება დამოკიდებულია პრეპარატის შემადგენლობაში შემავალი ფენოტეროლის მოქმედებასთან: პაციენტებში აღინიშნება თითების ტრემორი, გულის ფრიალის შეგრძნება, ტაქიკარდია
გვერდითი მოვლენების განვითარება აგრეთვე დაკავშირებულია პრეპარატის შემადგენლობაში შემავალი იპრატროპიუმის ბრომიდის მოქმედებასთან. ცალკეულ შემთხვევაში აღინიშნება პირის ღრუს სიმშრალე.

უკუჩვენება
- ორსულობის პერიოდის I ტრიმესტრი;
- პრეპარატის შემადგენლობაში შემავალი კომპონენტების მიმართ მომატებული მგრძნობელობა.
ორსულობა და ლაქტაცია
ბეროდუალის გამოყენება ორსულობის I ტრიმესტრში წინააღმდეგნაჩვენებია.
იმის გამო, რომ ფენოტეროლმა შესაძლებელია მშობიარობის აქტზე იმოქმედოს უარყოფითად, პრეპარატის გამოყენება უნდა შეწყდეს მშობიარობამდე რამოდენიმე ხნით ადრე.
ლაქტაციის პერიოდში პრეპარატის გამოყენების შესახებ არ არსებობს მონაცემები მისი შეზღუდვის საჭიროების შესახებ.

განსაკუთრებული მითითებები
ბეროდუალის გამოყენება გულ-სისხლძარღვთა სისტემის დაავადების დროს შესაძლებელია. ინჰალაციის შემდეგ მისი ჭარბი დოზი გამოყენების შემთხვევაშიც კი არ აღინიშნება კარდიოტოქსიკური რეაქციები.
ბეროდუალის საინჰალაციო ხსნარი ვარგისია სეკრეტორულ-მუკოლიზურ პრეპარატებთან კომბინაციაში.
პრეპარატის შემთხვევით თვალში მოხვედრისას აღინიშნება აკომოდაციის მსუბუქი ხარისხის დარღვევა, რომელიც ქრება თავისით გარკვეული პერიოდის შემდეგ.

ჭარბი დოზირება
სიმპტომები: თითების ტრემორი, გულის ფრიალი, ტაქიკარდია. მოსალოდნელია აგრეთვე არტერიულ სისტოლური და დიასტოლური წნევის დაქვეითება, მკერდის ძვლის მიდამოში სიმძიმის შეგრძნება, ხანდახან - ექსტრასსიტოლია, ბრონქოობსტრუქციმის გაძლიერება.
სხვა წამლებთან ურთიერთქმედება: ქსანტინის წარმოებულებთან, კრომოგლიცინის მჟავასთან და გლუკოკორტიკოსტეროიდულ საშუალებებთან კომბინაციისას ძლიერდება ბეროდუალის მოქმედება, ხოლო ბეტა-ადრენობლოკატორები ასუსტებენ მის ეფექტს.

შენახვის პირობები და ვადები
პრეპარატი ინახება არა უმეტეს 30oC ტემპერატურაზე, მშრალ, ბავშვებისაგან დაცულ ადგილას.ვარგისიანობის ვადა - 5 წელი.

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