The 9 Best Asthma Drugs

*Overview of the best according to the editors of Healthy Food Near Me. About selection criteria. This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.

Many articles have already been written on bronchial asthma, including a review of drugs. But medicine does not stand still, and more and more modern and combined medicines appear. The combinations are selected in such a way as to avoid tedious, frequent taking of tablets, frequent inhalations, and to simplify the regimens. This is called improving compliance. Compliance, if explained in simple terms, is the degree of patient adherence to treatment.

Adherence does not mean at all that the patient deliberately shows dishonesty, cunning, deceives the doctor, and refuses the prescribed drugs. Here we can talk about elementary forgetfulness, a complex scheme, inaccuracies in the concept of prescriptions and related omissions of medications.

It is clear that if the medicine needs to be taken once a day at the same time, then this prescription is much easier to follow than: take one tablet at 10:00 in the morning, 12 tablets at 30:6, 4 at 00:3 pills, and at 8:00 again six pills. And that’s in even numbers. And for odd numbers, another combination again. It is clear that it is much easier to violate the second prescription, its violation is inevitable, and it is simply a matter of time.

This is the first direction in the creation of combined anti-asthma drugs. In addition, new, highly effective drugs and drugs are simply being created that have a lower risk of side effects and contraindications, and even new classes of compounds and fundamentally new mechanisms of drug action are being discovered.

Before moving on to the list of really modern highly effective drugs for the treatment of bronchial asthma in the interictal period and for the relief of attacks, let’s remember what is called asthma.

What is bronchial asthma and how does it differ from heart disease?

Asthma is, first of all, periodic attacks of suffocation. The attack is accompanied by wheezing, shortness of breath, and shortness of breath occurs. But this definition is incomplete. Yes, it is important to point out that shortness of breath is associated with a violation of bronchial patency, and shortness of breath is precisely expiratory, that is, it occurs on exhalation. It is easy for a person with bronchial asthma (during an attack) to inhale air, but it is much more difficult to push it back out.

Not all choking is called bronchial asthma. She can be hearty too. The main symptom is also an attack of suffocation with difficulty breathing, but there will be a completely different reason and a completely different mechanism for the development of suffocation. If in bronchial asthma lack of air is associated with a change in bronchial conduction, then in cardiac asthma the cause is the release of the liquid part of the blood, that is, plasma from small capillaries, the appearance of abundant foamy pink sputum, and the impregnation of the lungs with liquid due to high pressure in the pulmonary circulation. Deterioration of gas exchange and causes shortness of breath.

Asthma can develop at any age, but now more and more often children’s asthma is registered for the first time, due to the deteriorating environmental situation in large cities, air pollution, and an increased allergic background in children. Asthma is more often first registered in boys, men are more often ill, and very often bronchial asthma is a family disease. It is very important to remember that the main factor for the development and progression of asthma is smoking. Smoking and asthma are completely incompatible.

There are several forms of bronchial asthma, but the mechanism for the development of an attack for all forms is common: the smooth muscles of the bronchi contract, they narrow, secondary inflammation of the mucous membrane of the bronchial tree occurs, and excess mucus is produced. Under conditions of altered bronchial reactivity, this mucus ceases to be excreted, the ciliary epithelium of the bronchi suffers, and as a result, small-caliber airways are clogged.

An allergic reaction can lead to this. This type of asthma begins in early childhood and is usually accompanied by hay fever, cereal allergies, various types of eczema, atopic dermatitis, and polyvalent food and household allergies. But if an adult has asthma, it is usually difficult to suspect an allergy to any particular substance. Usually the first attack is associated with a respiratory viral infection, and then the attack is provoked by some specific factor. This is the inhalation of cold air, stress, physical activity.

In addition to allergies, asthma can also be caused by exposure to a chemical, if it is inhaled for a long time at work, and personal protective equipment is neglected. Occupational asthma can be easily diagnosed if occupational hazards are known. And if they are not previously described during the certification of the workplace, then the search can be very long, because more than 200 different chemicals are currently known that can lead to the onset of bronchial asthma. How does typical asthma manifest itself? What are its symptoms?

Symptoms and signs of an asthma attack

Many of the symptoms and signs of asthma develop insidiously, gradually. And until the first and frightening attack, which is remembered forever, has not arisen, a person may not pay any attention to it. Developing symptoms can periodically lead to wheezing, some feeling of tightness in the chest. Periodically, there may be a feeling of obstruction to exhalation, a person may experience a dry cough. But if all these symptoms occur abruptly, are accompanied by a feeling of panic, shortness of breath, sharply aggravated at night and early in the morning, then this is a typical attack of bronchial asthma.

It should also be remembered that if there is a cold, SARS, or even a mild course of a coronavirus infection, then a person may have wheezing, and the same feeling of tightness in the chest. This does not mean that an attack of bronchial asthma has developed.

What causes a severe attack? Here are typical signs:

1. the whistle of air on exhalation is no longer audible, since very little air enters the lungs, and there is simply nothing to whistle with;

2. it is difficult for a person to speak. He begins and ends the phrase without finishing, as shortness of breath intensifies, and we speak sounds on the exhale;

3. the patient takes a forced posture: he sits on the bed, leaning his straight arms on the bed and straightening his torso. This allows you to connect additional respiratory muscles to facilitate respiratory movements;

4. his supraclavicular fossae and intercostal spaces are drawn in, you can see how he breathes with excruciating difficulty;

5. there is cyanosis, or cyanosis of the tongue, lips, fingers and toes. This indicates that too little oxygen is getting into the blood.

With a long course of an attack, or frequent repetitions of attacks, when they merge with each other, the patient may develop status asthmaticus. The condition worsens, cyanosis increases, psychomotor agitation is replaced by confusion, hypoxic coma sets in.

If an asthma attack occurs that does not stop, you need to call an ambulance, give oxygen and, if possible, hospitalize the patient in a specialized department.

The basic principles of treatment

The treatment of bronchial asthma is aimed at two goals: to eliminate the symptoms of the actual attack of bronchial asthma, to complete it. These are seizure medications. They are called so – cupping. The second goal is to make attacks as rare as possible, and to make them as easy as possible. These are medicines that are used in the interictal period, and they are called controllers.

It is much more convenient for patients with bronchial asthma to use inhalers, aerosol cans, which can immediately give the active substance into the respiratory tract in a strictly measured dosage. In the case of asthma in children, they should also use only aerosol cans, since they immediately give the required dose. Using pills to stop an attack is useless. To stop attacks, for example, bronchodilators are used, which relax the bronchial muscles, increase the lumen of the bronchi and eliminate respiratory dysfunction. The effect comes quickly, but does not last long, no longer than a few hours. In the interictal period, for example, corticosteroid drugs combined with bronchodilators and other drugs are prescribed.

Review articles on modern drugs can be written in such detail that they can be mistaken for instructions by a person who has no medical education. If drugs are described in detail for stopping an attack, and for treatment in the interictal period, then such a detailed presentation tempts the patient to himself, without a pulmonologist, to purchase drugs to stop an attack and start treatment. This self-treatment is unacceptable, since each case has its own unique feature, and the drug should be selected only by a doctor, taking into account contraindications.

Therefore, it was decided to avoid such a provocative way of presentation and simply list a few modern drugs from various groups used to treat asthma. The names of these drugs sound rather bizarre, and they are all relatively expensive by Russian standards.

They have no domestic analogues, and they are all produced by world pharmaceutical leaders, mainly from Western Europe. But all of them are sold on the territory of the Russian Federation, and there is no shortage of them, especially in large cities, regional and regional centers, not to mention the capitals, in 2020.

All these medicines are recommended by the national Russian clinical guidelines for pulmonologists for the treatment of bronchial asthma, and are included in the review due to their high effectiveness.

At the beginning, before the name of each drug, its pharmacological group is given, for example, an adrenomimetic. After that – the name according to the INN, that is, the international non-proprietary name. Further, in brackets, the commercial name is given, which the patient asks at the pharmacy. In other drug reviews, you could find several brand names, or generics, in brackets, but you will hardly find generics in this list of asthma drugs. Generics are quite easy to create and release if the drug is outdated, well-known, has flooded the market, contains only one component, and the substance can be purchased without any problems from several suppliers, its price is low, and the drug is in demand by many. Therefore, acetylsalicylic acid, meloxicam, and other drugs have a lot of popular generics in a very different price range.

The price of medicines is given as of mid-April 2020 for pharmacies of all forms of ownership in the Russian Federation. The price is indicated in the range from maximum to minimum. You can display the average price yourself.

Rating of the best drugs for asthma

β-2 adrenomimetic: Indacaterol (Onbrez Breezhaler)

Rating: 4.9

The first drug we have considered is a pure selective β-2 adrenomimetic indacaterol. This is a modern drug that is available in capsules. Inside there is a powder for inhalation, and one inhalation device is included in the package. Capsules come in two dosages: 150 mcg and 300 mcg. The cost of such a package of 30 capsules together with an inhalation device in the spring of 2020 in Russia is from 1500 to 1800 rubles. It is produced by the Swiss company Novartis Pharma.

How does the medicine work? After a single inhalation, Onbrez acts throughout the day, stimulating an increase in cAMP and relaxing the smooth muscles of the bronchi. Its selectivity is quite high, and it acts 20 times stronger on bronchial receptors than on β-receptors of other organs.

It is a control drug and its function is long-term maintenance therapy in case of deterioration of bronchial obstruction. The drug must be inhaled once a day at the same time. Treatment begins with a minimum dose, and the dose increases, with the transition to capsules of 300 mcg only at the discretion of the doctor.

The capsule is placed inside the inhaler, crushed until it clicks, and then, exhaling deeply, you need to take the most uniform full breath. The capsule powder with a characteristic rattling sound will be sprayed and absorbed into the bronchi. There may be a slight sweetish taste in the mouth. After inhaling, it is advisable to hold your breath as long as possible, exhale and see if there is any powder left in the capsule. If the powder remains, you need to inhale again. After inhalation, a cough may occur, but this is not terrible, which means that the patient has received a full dose.

Advantages and disadvantages

Onbrez Breezhaler improves lung function for a long time throughout the day, quickly begins to act, and the maximum effect develops 3 hours after inhalation. The drug can be taken regardless of the time of day, in the morning or in the evening, but at the same time. It increases inspiratory capacity, increases exercise tolerance, and reduces the risk of exacerbation of chronic obstructive pulmonary disease.

But still, this is a rather serious drug, and contraindications will be pregnancy, breastfeeding, age up to 18 years. There are a large number of diseases when great care is needed, and, basically, these are concomitant diseases of the cardiovascular system.

Of the side effects, there can often be manifestations of nasopharyngitis, and discomfort in the throat and upper respiratory tract, sometimes cough, rash and itching, muscle spasm, and dry mouth often occurs. In some cases, an increase in blood sugar levels and peripheral edema may occur, so patients must begin treatment under the supervision of a physician. There are also many drug interactions. This must be determined by the doctor.

There are also special instructions. The patient may develop paradoxical bronchospasm, decrease the level of potassium, and adverse events from the cardiovascular system may occur. But if you evaluate all the risks and find out everything from the patient before taking it, and monitor the tests against the background of the appointment, then this modern drug will significantly improve the quality of life, and make the attacks less frequent, and not so pronounced.

β-2 adrenomimetic + hormone: fluticasone furoate + vilanterol (Relvar Ellipta)

Rating: 4.8

This drug is also not intended for the relief of an attack of bronchial asthma, but only for long-term interictal treatment. For relief, short-acting adrenomimetics should be used. Relvar Ellipta contains the β-2 adrenomimetic vilanterol and the corticosteroid hormone fluticasone, in the form of furoate.

The drug belongs to the combined bronchodilators, and is used not only for the planned treatment of bronchial asthma, but also for chronic obstructive pulmonary disease, chronic bronchitis, and other pathologies. The drug is produced in the form of a special plastic inhaler, into which 30 doses are immediately filled, like cartridges in a magazine. One pack of 30 doses can contain either 92 micrograms of the hormone per dose, or twice as much hormone. As a result, the price will also vary. A package of 30 doses of a low dosage of the hormone will cost 1800-2100 rubles, and a large dosage of 2150-2500 rubles. This medicine is produced by the English company Glaxo.

These two drugs, a synthetic glucocorticosteroid and a selective long-term adrenomimetic, act synergistically. The hormone has a pronounced anti-inflammatory effect, and vilanterol, as in the previous case, increases the level of cAMP and relaxes the smooth muscles of the bronchi.

The indication for the appointment of this drug, first of all, is bronchial asthma, its planned, interictal, supportive therapy. Also, the drug is used for chronic obstructive pulmonary disease, and also as maintenance therapy. The agent is used by inhalation, once a day and preferably at the same time. After inhalation, rinse your mouth with water and spit it out. The drug should be taken regularly, and without interruption.

All the capsules have already been filled into the inhaler, and if you open and close the lid of the inhaler, but do not inhale the agent, then one dose is wasted. It is sprayed inside the inhaler, but will not be available for admission. As soon as the patient opens the cap, one dose is sprayed inside and becomes ready for inhalation and deep inspiration. Automatically in the inhaler there is a counter of medicinal doses, which reduces their number from 30 to 0, and the numbers become redder, approaching zero. Therefore, it is impossible to forget or confuse how many days the drug was taken daily.

Advantages and disadvantages

The combination of a hormone and an adrenomimetic is more stable and powerful, in addition to a long-term effect on the bronchial muscles, the second component leading to bronchospasm, namely inflammation, is eliminated or weakened. Inflammation stops the inhalation of the hormone.

Contraindications include a severe allergy to milk protein, as it is part of the spray mixture, children under 12 years of age. Also, Relvar Ellipta High Dose Hormone, 184 micrograms per capsule, is not indicated for the treatment of chronic obstructive pulmonary disease, but is used only for the treatment of asthma.

Caution should be used in patients with heart disease, with arrhythmia and extrasystole, with various infections, including chronic and untreated. It should be remembered that glucocorticosteroid hormones significantly worsen the indicators of immunity on the mucous membranes with prolonged use. There may be side effects, and oral and pharyngeal candidiasis may occur, headache, nasopharyngitis symptoms, abdominal discomfort, back and joint pain, and even fever may develop.

But these side effects are quite rare, and the asthma patient should take this remedy regularly, if prescribed, even if there are no symptoms of the disease, that is, asthma attacks. The patient should regularly see a doctor to check his condition.

Monoclonal antibodies: omalizumab (Xolar)

Rating: 4.7

This is by far the most expensive drug on the list. The cost of one package (150 mg) is more than 16000 rubles, but this price is justified by the method of production. In order to obtain monoclonal antibodies, chemical synthesis, the main way to create drugs, is unsuitable. Molecular biotechnology is needed. In the DNA of industrial cultures of microorganisms, it is necessary to create, and introduce, engraft a certain sequence of amino acids. After that, living organisms will begin to synthesize the necessary antibodies in large quantities, as one resembling the other. Since they are made from a single clone, they are called monoclonal.

These antibodies selectively bind to Ig E, which plays a critical role in triggering an allergic immune response in patients with atopic bronchial asthma. As a result, the amount of free class E immunoglobulins decreases, the cascade of allergic reactions is inhibited, and the condition of patients with atopic bronchial asthma improves significantly. There is a significant decrease in the frequency of exacerbations, less need to take glucocorticoid hormones, or in general, the need for hormones in patients with atopic bronchial asthma disappears completely. It is necessary to use this medicine for a long time. For the effect to come, you need at least 4 months to pass. The course of treatment can be several years, and if possible – longer.

The drug is indicated for use only in patients with allergic bronchial asthma, that is, with the presence of atopy, and in case of a severe course, when high doses of hormones are needed. You can start using the medicine from the age of six, you can prescribe it in case of severe idiopathic urticaria.

Xolair is the only asthma drug that must be administered strictly subcutaneously. The recommended dose is related to the initial concentration of immunoglobulin E in the blood plasma, which must be determined before treatment, since, depending on the immunoglobulin, the dosage may differ by almost 10 times. You need to administer the medicine once every 2 weeks, or once a month.

What is the cost of treatment? 16000 rubles is worth one bottle, which contains 150 mg of the substance. If:

1. in a patient, the initial concentration of immunoglobulin E in the blood plasma does not exceed 300 IU / ml, then such an injection can be given subcutaneously once every 4 weeks, that is, once a month, to a child if the body weight does not exceed 25 kg;

2. if we are talking about an adult, then he can enter such a dosage once a month, if his initial concentration of immunoglobulin E does not exceed 100 units, and his own body weight will be in the range from 60 to 90 kg;

3. if the body weight of an adult is 75 kg, but his immunoglobulin concentration is from 300 to 400 units, then he needs to inject 600 mg once a month, that is, four vials, in other words, the cost of the course of treatment will be 64000 rubles. per month.

The thing is that the concentration of immunoglobulin E can exceed both 500 and 700 units, and then it will be necessary to administer this drug once every 2 weeks.

In addition, there is a limit on the maximum amount of the administered drug. It should not exceed 600 mg every 2 weeks. And if the patient’s amount of immunoglobulin E exceeds 1000 units, then this drug can be prescribed to him only if his body weight does not exceed 60 kg. If he is heavier, then he will need to inject an even larger dosage, and this is the maximum amount that can be administered safely. Therefore, the maximum amount of the drug that can be administered within a month is 1200 mg, or 8 vials, or 128 thousand rubles per month for long-term, long-term treatment.

Advantages and disadvantages

This is a replacement therapy drug, so it can ideally be used for life to suppress the concentration of immunoglobulin E. The first and most important drawback is its too high cost, or, more precisely, the too low standard of living of Russians. Only a few in Russia can afford to spend so much a month on the treatment of bronchial asthma, and additionally purchase more drugs, albeit in small quantities. The drug has a large number of side effects, contraindications, which make up more than one page of instructions. After all, it is necessary to prescribe omalizumab only if the patient can guarantee its use for at least six months in order to achieve any results. After discontinuation of treatment, the level of immunoglobulin E gradually returns to its previous value, and the patient again needs glucocorticosteroid hormones and high dosages of drugs.

Olodaterol + tiotropium bromide (Spiolto Respimat)

Rating: 4.7

Boehringer Ingelheim inhalation solution containing 2,5 mcg of each component in a single dose. Cartridges of 4 ml for inhalation, the cost is from 2700 to 3300 rubles. The drug has the effect of an m-anticholinergic blocker, together with an adrenomimetic. As a result, the two components complement each other, enhancing the expansion of the bronchi, since each has its own mechanism. We already know how the adrenomimetic works, through adenylate cyclase and the synthesis of cyclic AMP. The adrenomimetic acts for at least a day, and tiatropium bromide affects muscarinic receptors, and also relaxes the smooth muscles of the bronchi, the effect also lasts at least a day. The drug works better than inhalation of both components alone, and significantly improves exercise tolerance. It is indicated for planned, long-term maintenance therapy of bronchial asthma, and chronic obstructive pulmonary disease. Inhalation is performed through a special inhaler into which a cartridge is inserted, it is pierced, and the inhaler contains 30 therapeutic doses for a month.

Advantages and disadvantages

The synergism of the anticholinergic and adrenomimetic allows you to achieve a lasting effect from 1-2 daily inhalations, more than for a day. Spiolto Respimat is contraindicated in persons under the age of eighteen, with hypersensitivity to any of the components. With caution, but can be used for glaucoma, prostatic hyperplasia, bladder neck obstruction, that is, for all conditions when an anticholinergic can harm. It is necessary to be careful with diseases of the cardiovascular system, with hypertension, thyrotoxicosis, when a beta-blocker can damage. There may be side effects, and most often it is dry mouth associated with an anticholinergic.

Cyclesonide (Alvesco)

Rating: 4.7

This drug is a pure hormone and contains ciclesonide. The substance itself has a rather low affinity for glucocorticosteroid receptors, and only after it has been treated with enzymes, having hit the bronchial mucosa, does it turn into the main metabolite with pronounced anti-inflammatory activity. It is shown only in bronchial asthma, and suppresses the inflammatory response, reducing the symptoms of an attack. This remedy is not intended to relieve seizures, but is used for a long period of time daily.

For mild asthma, the daily dose is 160 to 640 micrograms. The balloon does not need to be shaken as the aerosol is dissolved. There are three options for the drug: in one spray it can be 40 mcg, 80 and 160 mg, depending on the indications, and the doctor’s prescription, and you should buy yourself an aerosol. Alvesco is produced by the Nycomed company in Austria, and the aerosol in the largest dosage, 160 μg of ciclesonide, can be purchased at prices ranging from 1600 to 2300 rubles.

Advantages and disadvantages

The drug has very limited contraindications. In addition to hypersensitivity, this is age under 6 years, pulmonary tuberculosis, as well as chronic respiratory tract infections, viral, fungal and bacterial, since any corticosteroid depresses local immunity. Side effects may include nausea, sore throat, headache and cough after inhalation. Alvesco is used in the event that non-hormonal agents fail to make attacks easier or less frequent, so the use of hormones is necessary. If Alvesco is used for a long time, then it is necessary to control the function of the adrenal cortex, since the drug can inhibit it.

Aclidinium bromide (Bretharis Genuair)

Rating: 4.6

This medicine for the treatment of asthma and COPD is produced by AstraZeneca. The inhaler contains powder at a dosage of 322 micrograms per dose, and it costs from 2300 to 3000 rubles. for a pack of 60 doses. Bretaris Genuair is an m-cholinergic receptor blocker, and we have already met with the blocker, it was part of the drug Spiolto Respimat. Here is an isolated anticholinergic, which should support bronchodilatory treatment in order to alleviate the symptoms of asthma and COPD in adults. It acts indirectly through muscarinic receptors, as a result, expanding the lumen of the bronchi by weakening their smooth muscles.

You need to take one inhalation twice a day, so one package is enough for a month. If you miss one dose, then you should take it as soon as possible, but if too much time has passed, and you realized it only the next day, when it was time for a new dose, then you should not make up for the missed dose. The inhaler is equipped with a counter.

Advantages and disadvantages

Bretaris Genuair has been proven to improve the function of external respiration, after taking it in the morning and in the evening, it lasts for 12 hours, and if you take the first dose in the morning, the improvement occurs within 30 minutes. The maximum effect appears after 2 hours, and persists for 12 hours, before taking the second dose. Thus, protection of the bronchopulmonary system during the day is obtained. The drug does not critically affect the heart rate, and long-term treatment for 6 months reduces asthma attacks, reduces shortness of breath, and improves respiratory quality. Studies have shown an increase in exercise tolerance, with headache and symptoms of nasopharyngitis being the most commonly reported side effects. However, one should also remember about the general contraindications associated with anticholinergics. This is the presence of angle-closure glaucoma, prostate adenoma or bladder pathology associated with reflex urinary retention.

Montelukast (Singular)

Rating: 4.5

Montelukast is a completely new drug of the XNUMXst century, which is just a new group of drugs in the treatment of not only atopic bronchial asthma, but also other allergic diseases, such as seasonal allergic rhinitis, hay fever. Montelukast, or Singular, belongs to a special class of leukotriene receptor blockers. Leukotrienes are one of the important mediators of inflammation, and in bronchial asthma and allergic diseases of the upper respiratory tract, they are included in the cycle of inflammatory reactions, and cause bronchospasm, increase vascular permeability, and increase mucus secretion. Singular has high selectivity and high affinity for leukotriene receptors, and causes their blockade in the airways. This allows you to block bronchospasm, and relax the bronchi within two hours after ingestion.

Surprisingly, Singular works effectively not in inhalations, as is usually done in the treatment of bronchial asthma, in tablets, and the indications include not only long-term treatment of bronchial asthma, but also prevention, as well as relief of allergic and seasonal rhinitis, starting from the age of 15 . In adults, Singulair is very easy to use: just once a day, regardless of food intake, one tablet, 10 mg. Singulair is produced by the world-famous company Merck Sharp & Dohme located in the Netherlands, and a package of 28 tablets, designed for a monthly intake, will cost from 1530 to 1960 rubles.

Advantages and disadvantages

The advantage will be a favorable economic profile, a special mechanism of action that will not interfere with traditional adrenomimetics, anticholinergics and hormones. This will significantly improve the patient’s condition, the attacks will become less frequent and not so strong, and the number of drugs, and especially hormones, can be reduced. However, the drug has contraindications, but they are very modest: hypersensitivity to montelukast, lactose intolerance, due to the fact that the component is included in the shell of the tablets, as well as children under 15 years of age. Side effects are mild, non-essential, and most often diarrhea.

Ipratropium bromide + fenoterol (Berodual)

Rating: 4.4

Berodual is an old and long-known inexpensive drug that can be considered combined. It also includes the beta-agonist fenoterol, and the anticholinergic ipratropium bromide, and this combination has already been on the list. However, Berodual is cheaper and is used very widely in the Russian Federation. The spectrum of application is asthma and obstructive pulmonary disease, emphysema and chronic bronchitis. It is available in the form of a liquid, which is used in the form of inhalation. Bronchodilation is due to this drug by local action, and not at all by a systemic effect. The drug is indicated for the symptomatic treatment of any obstructive processes, including those with the presence of emphysema.

It is necessary to use it in inhalations in adults with acute attacks of bronchospasm from 20 to 50 drops, while the recommended dose is diluted to a volume of 3-4 ml with saline. Since 1 ml is 20 drops, it is enough to add 2-3 ml of saline. Berodual is manufactured by Boehringer Ingelheim. Its cost is from 250 to 290 rubles per bottle of 1 ml. Solution for inhalation should not be used in drops inside.

Advantages and disadvantages

The advantage of Berodual is normal, clinically proven efficacy, although the components are not the newest, low price, and good tolerance, rich, accumulated clinical experience. Contraindications include hypersensitivity to the components, obstructive cardiomyopathy, tachycardia and palpitations, as well as the first trimester of pregnancy. It should be used with caution in glaucoma, prostate adenoma, severe heart damage, and urinary tract obstruction: precautions are quite standard for adrenomimetics and anticholinergics. The most common side effects are dry mouth, coughing, and other reactions.

Intal

Rating: 4.3

In conclusion of the list, consider the second drug, long known to pulmonologists – this is sodium cromoglycate, or Intal. This is also a special group of drugs, and it belongs to the catalysts of mast cells. Intal is used for various types of asthma, both as a solution for inhalation and as an aerosol. Each bottle can contain 200 doses, or 112, and the inhalation solution is sold in 2 ml ampoules, 48 ​​pieces per pack. The task of Intal is to slow down the release of inflammatory mediators from mast cells, they are the ones that trigger the entire allergic cascade. Other drugs fight other stages of the cascade: montelukast inhibits leukotriene receptors, glucocorticoid hormones contribute to an overall reduction in inflammation. Intal can be used both for the prevention and treatment of bronchial asthma, that is, both in the period between attacks and during attacks. Aerosol for inhalation for adults and children is prescribed 2 inhalations four times a day, with a possible increase in dose up to 6-8 times a day. Also, an increased concentration is necessary according to indications in conditions of high concentration of allergens, for example, during the flowering season of grasses. Intal is manufactured by Aventis.

Advantages and disadvantages

The advantage of sodium cromoglycate can be considered its good tolerability, low number of side effects, for example, only cough and irritation of the respiratory tract. The advantage will be the absence of contraindications, except for hypersensitivity, the ability to combine it with all other drugs, and use it not only for prevention, but also for the treatment of asthma attacks. The negative fact can be considered the absence of it in the pharmacy network, it is very rare. It can often be bought as a nasal spray to treat and prevent allergic rhinitis.

Conclusion

From the listed preparations it is clear how far science has gone forward. At the end of the 2th century, the attack was stopped with ephedrine, eufillin, and the first selective beta-XNUMX adrenoreceptors, such as Izadrin and others, have just begun to appear. Rough atropine was used, amidopyrine and diphenhydramine were offered to stop asthma, adrenaline was used, and prednisolone and even adrenocorticotropic hormone known then. In the interictal period, triamcinolone, antimalarial drugs were prescribed, and in case of bronchospasm with difficult sputum production, a solution of potassium iodide, ammonium chloride and other ancestors of modern expectorants and mucolytics were used. Now that we have leukotriene receptor blockers and monoclonal antibodies in the treatment of bronchial asthma, it is hard to believe that until recently these drugs were not available, the treatment of attacks was crude and imperfect. We hope that in the near future new classes of drugs will appear, and bronchial asthma will be defeated as a disease.

Attention! This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.