Indications
Bronchospasm: Azmasol Inhaler is prescribed for treating or preventing bronchospasm in bronchial asthma. It is also effective in treating reversible airway obstruction linked with bronchitis and emphysema.
Exercise-Induced Bronchospasm: Azmasol Inhaler can alleviate acute breathing difficulties (dyspnea) and can be used as a preventive measure before exercise to avoid asthma triggered by physical exertion.
Pharmacology
Salbutamol, the active ingredient in Azmasol, is a selective β2-adrenoceptor agonist. At therapeutic doses, it primarily targets β2 receptors in the bronchial smooth muscles, with minimal impact on β1 receptors in the heart. Salbutamol provides rapid bronchodilation (within 5 minutes) that lasts for 4-6 hours, effectively treating reversible airway obstruction. Additionally, it exhibits anti-inflammatory effects by inhibiting the release of bronchoconstrictors such as histamine, neutrophil chemotactic factors, and prostaglandin D2.
Dosage
Administer the Salbutamol Inhaler through oral inhalation only. Shake well before each use.
For Acute Bronchospasm:
- Adults: 1-2 puffs as needed. Maximum dose: 8 puffs in 24 hours.
- Children: Half of the adult dose.
For Prevention of Exercise- or Allergen-Induced Bronchospasm:
- Adults: 2 puffs 15 minutes before exercise or allergen exposure. Maximum: 2 puffs up to 4 times a day.
- Children: Half of the adult dose.
Chronic Therapy:
- Adults: Up to 200 mcg (2 puffs) four times a day.
- Children: Up to 200 mcg (2 puffs) four times a day.
Administration
Using an inhaler may seem simple, but improper technique can result in less medication reaching the lungs. Proper and consistent use is crucial for reducing asthma attacks.
To use the inhaler effectively, follow these steps (based on guidelines from the National Asthma Association):
- Remove the cap.
- Shake the inhaler at least six times before use.
- If new or unused for over a week, shake and release one puff to ensure functionality.
- Breathe out fully, holding the inhaler upright.
- Insert the mouthpiece between your teeth, sealing your lips around it.
- Inhale deeply and slowly while pressing the canister to release the medication.
- Remove the inhaler and hold your breath for at least 10 seconds.
- If more puffs are prescribed, wait 1 minute between doses. Shake and repeat steps 4-7.
- After use, replace the cap. Rinse your mouth with water.
For best results, periodically check your inhalation technique in front of a mirror. If you notice a white mist escaping, you may not be inhaling correctly. Repeat the process carefully if this occurs.
Cleaning Instructions: Clean the inhaler at least once a week by removing the canister and rinsing the plastic actuator and cap with warm water. Do not submerge the metal canister. Dry thoroughly before reassembling.
Use only as directed by a physician.
Interaction
Azmasol should not be used alongside non-selective beta-blockers such as propranolol. β2-agonist treatments can cause low potassium levels (hypokalaemia), especially when used with xanthine derivatives, steroids, diuretics, or in cases of severe asthma. Regular monitoring of potassium levels is recommended.
Contraindications
Azmasol Inhaler should not be used by patients with a known hypersensitivity to salbutamol or any other components of the formulation.
Side Effects
Azmasol is generally well-tolerated. Some patients may experience mild side effects such as tremors, anxiety, muscle cramps, headaches, palpitations, and a slight increase in heart rate. In rare cases, more serious conditions like arrhythmias, tachycardia, or throat irritation can occur.
Pregnancy & Lactation
Azmasol Inhaler is categorized as Pregnancy Category C. While there are no sufficient studies on its safety during pregnancy, it should be used only if the potential benefits justify the risks. It is unclear if salbutamol is excreted in human breast milk, so caution is advised when using this medication while nursing.
Precautions & Warnings
Paradoxical Bronchospasm: This inhaler may cause paradoxical bronchospasm, a potentially life-threatening condition. If this occurs, discontinue use immediately and seek alternative treatment.
Cardiovascular Effects: Azmasol may cause significant changes in heart rate or blood pressure in some patients. If cardiovascular symptoms arise, discontinue use. Patients with heart conditions, such as arrhythmias or coronary insufficiency, should use this medication with caution.
Immediate Hypersensitivity: Rare but serious allergic reactions, including anaphylaxis, have been reported with Azmasol use. Discontinue if symptoms of hypersensitivity occur.
Other Conditions: Azmasol should be used cautiously in patients with conditions like convulsive disorders, hyperthyroidism, or diabetes.
Use in Special Populations
Children: The safety of Azmasol in children aged 4 and older has been established.
Storage Conditions
Keep the canister in a cool place below 30°C. Avoid exposure to heat, sunlight, or freezing temperatures. Keep out of reach of children and avoid eye contact. Only use under the prescription of a registered healthcare provider.
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