Beclomethasone

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Beclomethasone

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Beclomethasone is for inhalation use only.

Beclomethasone is used regularly (even in the absence of symptoms of the disease), the dose of beclomethasone dipropionate is selected taking into account the clinical effect in each particular case.

With mild bronchial asthma, forced inspiratory volume (FEV) or peak expiratory flow rate (PSV) make up more than 80% of proper values ​​with a spread of PSV values ​​of less than 20%.

With a moderate course of FEV or PSV is 60-80% of the proper values, the daily variation of PSV is 20-30%.

In case of severe FEV or PSV, 60% of the required values, the daily variation of PSV values ​​is more than 30%.

When switching to a high dose of inhalation beclomethasone dipropionate, many patients receiving systemic glucocorticosteroids will be able to reduce their dose, cancel them altogether.

The initial dose of beclomethasone is determined by the severity of bronchial asthma. The daily dose is divided into several doses.

Depending on the patient's individual response, the dose of the drug can be increased until the clinical effect appears or reduced to the minimum effective dose.

Children aged 4 to 12 years

The initial dose is 50 mg 2 times a day. If necessary, the initial dose can be increased to 100 μg 2 times a day. The maximum single dose of 200 micrograms.

The maximum daily dose is 400 micrograms. The daily dose is divided into 2-4 doses.

Adults and children aged 12 and over:

Recommended initial doses of the drug:

• bronchial asthma of the lungs - 200-600 mg / day;
• moderate bronchial asthma - 600-1000 mcg / day;
• severe bronchial asthma - 1000-2000 mcg / day.

The treatment of bronchial asthma is based on a stepwise approach - the therapy is started according to the degree corresponding to the severity of the disease. Inhalation GCS is prescribed for the second stage of therapy.

Stage 2. Basic therapy.

Beclomethasone dipropionate 100-400 mcg 2 times a day.

Stage 3. Basic therapy.

Apply inhaled GCS in a high dose or in a standard dose, but in combination with inhaled long-acting p-2 adrenomimetics.

Beclomethasone dipropionate in a high dose - 800-1600 mg / day, in some cases, megadoses up to 2000 mg / day.

Step 4. Severe asthma.

Beclomethasone dipropionate in a high dose - 800-1600 mg / day, in some cases, megadoses up to 2000 mg / day.

Step 5. Severe asthma.

Beclomethasone dipropionate in a high dose (see steps 3 and 4).

Special patient groups

There is no need to adjust the dose of beclomethasone in the elderly, in patients with renal or hepatic insufficiency.

Skip taking one dose of the drug

In case of accidental omission of inhalation, the next dose should be taken at the appropriate time in accordance with the treatment regimen.

Instructions for the patient to use the inhaler

Check the operation of the inhaler before using it for the first time, and also if you have not used it for a while, or if the bottle was cooled to a low temperature, and then you warmed it to room temperature. To check, remove the protective cap from the nozzle inhaler, turn the balloon upside down, putting your index finger on the bottom of the bottle and your thumb on the top of the nozzle inhaler, shake the cartridge up and down and make 2 presses with your thumb and forefinger, pointing the nozzle outlet -ingulator aside. After the appearance of the aerosol spray after the second pressing, proceed as described below, beginning with the words: “Ensure that there is no dust and dirt in the outlet tube”.

With regular use of the drug should do the following:

• Remove the protective cap from the nozzle inhaler. Make sure there is no dust or dirt in the outlet tube.
• Hold the bottle upright with the bottom facing up, with your index finger on the bottom of the bottle and your thumb on the top of the inhaler tip. Shake the can up and down.
• Exhale as deeply as possible (without tension). Clamp the inhaler nozzle outlet tightly with your lips.
• Take a slow deep breath. At the moment of inhalation by pressing your thumb and forefinger, release a dose of the drug. Keep breathing slowly.
• Remove the inhaler tube from your mouth and hold your breath for 10 seconds or as much as you can without tension. Exhale slowly.
• If more than one dose of medication is required, wait for about a minute and then repeat steps from step 2. Put the protective cap back on the inhaler tip.

Do not rush through steps 3 and 4. At the time of release of a dose of medicine, it is important to breathe in as slowly as possible. First practice in front of the mirror. If you notice steam coming out of the corners of your mouth, then start again from step 2.

Cleaning the inhaler.

The inhaler cap should be cleaned at least once a week. Remove the nozzle inhaler from the bottle and rinse it and the protective cap with warm water. Do not use hot water. Dry thoroughly, but do not use heating devices for this. Put the protective cap back on the nozzle inhaler, and its - on the balloon. Do not dip the balloon in water.

Before the appointment of inhaled drugs, it is necessary to instruct the patient about the rules of their use, ensuring the most complete ingestion of the drug in the desired areas of the lungs. The development of oral candidiasis is most likely in patients with a high level of precipitating antibodies in the blood against Candida fungus, which indicates a previous fungal infection. After inhalation, rinse the mouth and throat with water.For the treatment of candidiasis, you can use local antifungal drugs while continuing therapy with Beclomethasone.
If patients take GCS orally, then Beclomethasone is prescribed while taking the previous dose of GCS, while patients should be in a relatively stable state. About 1-2 weeks later, the daily dose of oral GCS is gradually reduced. The dose reduction scheme depends on the duration of the previous therapy and on the magnitude of the initial dose of GCS. Regular use of inhaled corticosteroids allows, in most cases, abolishing oral corticosteroids (patients requiring no more than 15 mg of prednisolone can be fully transferred to inhalation therapy). At the same time, in the first months after the transition, the patient’s condition should be carefully monitored until his pituitary-adrenal system is restored sufficiently to ensure an adequate response to stressful situations (for example, trauma, surgery or infection).
When transferring patients from taking systemic corticosteroids to inhalation therapy, allergic reactions (for example, allergic rhinitis, eczema), which were previously suppressed by systemic drugs, can manifest themselves.
Patients with a reduced function of the adrenal cortex, transferred to inhalation treatment, should have a supply of corticosteroids and always carry a warning card, which should indicate that they need additional systemic corticosteroids in stressful situations (after eliminating the stressful situation, the dose of corticosteroids can again reduce). A sudden and progressive worsening of asthma symptoms is a potentially dangerous condition, not infrequently life-threatening to the patient, and requires an increase in the dose of GCS. An indirect indicator of the ineffectiveness of therapy is the more frequent use of 0-2-adrenostimulyatorov short-acting.
Beclomethasone dipropionate for inhalation is not intended to relieve seizures, but for regular daily use. For the relief of attacks, 3–2 short-acting adrenergic stimulants (for example, salbutamol) are used. With severe exacerbation of bronchial asthma or insufficient efficacy of therapy, the dose of inhalation beclomethasone dipropionate should be increased and, if necessary, systemic GCS and antibiotic should be administered during infection.
With the development of paradoxical bronchospasm, you should immediately stop the use of beclomethasone, assess the patient's condition, conduct an examination and, if necessary, prescribe therapy with other drugs. With prolonged use of any inhaled GCS, especially in high doses, systemic effects may occur (see “Side Effects”), but the probability of their development is significantly lower than when taking GCS orally. Therefore, it is especially important that when the therapeutic effect is achieved, the dose of inhaled GCS is reduced to the minimum effective dose controlling the course of the disease. At a dose of 1500 mcg / day, the drug in most patients does not cause significant suppression of adrenal function. In connection with possible adrenal insufficiency, special care should be taken and the indicators of the function of the adrenal cortex should be regularly monitored when transferring patients taking GCS orally for treatment with beclomethasone.
It is recommended to regularly monitor the growth of children receiving inhaled GCS for a long time.
The introduction can be carried out using special dispensers (spacers), which improve the distribution of the drug in the lungs and reduce the risk of side effects.
It is not recommended abrupt withdrawal of the drug Beclomethasone aerosol.
It is necessary to protect the eyes from getting the drug. Washing after inhalation can prevent damage to the skin of the eyelids and nose.
You cannot pierce, disassemble or throw into the fire even if it is empty. Like most other inhalants in aerosol packaging, Beclomethasone may be less effective at low temperatures. When cooling the cylinder, it is recommended to remove the inhaler attachment from it and warm it with your hands for a few minutes.
Influence on ability to drive vehicles and mechanisms
No data.

Symptoms:
Acute overdose of the drug can lead to a temporary decrease in the function of the adrenal cortex, which does not require emergency therapy, since the function of the adrenal cortex is restored within a few days, which is confirmed by plasma cortisol concentration. In chronic overdose, persistent suppression of the function of the adrenal cortex can be observed.
Treatment:
In such cases, it is recommended to monitor the reserve function of the adrenal cortex. In case of overdose, treatment with beclomethasone dipropionate can be continued in doses sufficient to maintain a therapeutic effect.