Salbutamol + Beclomethasone inhaler

Salbutamol + Beclomethasone inhaler is used for: Treatment of asthma

Adults: Inhaler 2 inhalations 3 or 4 times daily

Inhaler Child> 12 years: 2 inhalations, 3 or 4 times daily

Hypersensitivity to any of the components

Hyperthyroidism, myocardial insufficiency, arrhythmias, susceptibility to QT-interval prolongation, HTN, DM, glaucoma, hypokalaemia, seizure disorder. Renal impairment. Elderly. Pregnancy and lactation. Monitoring Parameters Monitor BP, heart rate, electrolyte and fluid balance; glucose, lactate and K levels.

Side effects of Salbutamol + Beclomethasone inhaler : Common side effects reported by greater than 2% in adults and adolescents were pain, dizziness, asthma, pharyngitis, and rhinitis whereas those observed in children were vomiting, bronchitis and pharyngitis; less than 2% were cyst, flu syndrome, viral infection, constipation, gastroenteritis, myalgia, hypertension, epistaxis, lung disorder, acne, herpes simplex, conjunctivitis, ear pain, dysmenorrhea, hematuria, and vaginal moniliasis. In children, frequently occurring adverse events were accidental injury, vomiting, bronchitis, pharyngitis. The incidence of systemic beta-adrenergic adverse effects (e.g., tremor, nervousness) was low. Potentially serious hypokalaemia may result from beta2-agonist therapy. This effect may be potentiated by hypoxia. Particular caution is advised in severe asthma in such cases, monitoring of serum potassium levels is recommended. Candidiasis of the mouth and throat (thrush) may occur in some patients (Gargling with water after inhalation may relieve this), hypersensitivity reactions, easy bruising of the skin, skin thinning, adrenal suppression, growth retardation in children and adolescents, hoarseness and throat irritation, upper respiratory tract infection, nasopharyngitis, oropharyngeal pain, viral upper respiratory tract infection, sinusitis, rhinitis allergic, cough, vomiting, headache, pyrexia are common. Very rare include Cushing's syndrome, Cushingoid features, decrease in bone mineral density, cataract, glaucoma, paradoxical bronchospasm, rashes, urticaria, pruritus, erythema, oedema of the eyes, face, lips and throat, respiratory symptoms (dyspnoea and/or bronchospasm), eosinophilic pneumonia and anaphylactoid/anaphylactic reactions, anxiety, sleep disorders and behavioural changes, including psychomotor hyperactivity, irritability (predominantly in children), depression and aggression. Other common respiratory effects were throat irritation and pharyngitis. Other adverse events reported with beclomethasone were nausea, pain, myalgia, diarrhea, ear infection, influenza, gastroenteritis viral. In some patients, inhaled beclomethasone dipropionate may cause hoarseness or throat irritation. It may be helpful to rinse out the mouth with water immediately after inhalation.

Salbutamol activates adenyl cyclase, the enzyme that stimulates the production of cyclic adenosine-3', 5'-monophosphate (cAMP). Increased cAMP leads to activation of protein kinase A, which inhibits phosphorylation of myosin and lowers intracellular ionic Ca concentrations, resulting in smooth muscle relaxation. Patient w/ bacterial (e.g. active or quiescent pulmonary TB), fungal, parasitic, and viral (e.g. chickenpox, measles, ocular herpes simplex) infection, DM, gastro-duodenal ulcer, serious arterial HTN, myasthenia gravis, MI, osteoporosis, hypoadrenalism, glaucoma, cataract, seizure disorder, depression, previous steroid-related psychosis, recent nasal septal ulcers, trauma, and surgery. Renal and hepatic (e.g. cirrhosis) impairment. Childn, Pregnancy and lactation. Patient Counselling Rinse mouth thoroughly after inhalation. Beclometasone (as diproprionate) is a prodrug w/ potent glucocorticoid and weak mineralocorticoid activity. It controls the rate of protein synthesis, depresses the migration of polymorphonuclear leukocytes, reduces fibroblast activity, and reverses capillary permeability and lysosomal stabilisation at the cellular level to prevent or control inflammation.