Zencombi CPC1HN controlled bronchospasm (10 vials x 2.5ml)

Dosage form Box of 10 vials x 2.5ml
Specifications Ipratropium bromid, salbutamol

Ingredient

Composition information	Content
Ipratropium bromid	0.5mg
Salbutamol	2.5mg

Uses

indications

Zencombi drugs are indicated to control bronchodial spasms with recovery due to respiratory obstruction in patients who need more than 1 bronchodilator.

Pharmacokinatics

ipratropium bromid is an antacidic drug acetylcholin, so it has a sympathetic inhibitor. When sprayed, inhaled, the drug has a selective effect, causes bronchial smooth muscle relaxation without affecting the excretion of bronchial mucus, to other functions of the body, especially the function of the heart, vascular, eye and gastrointestinal tract.

salbutamol:

Salbutamol has a selective effect to stimulate the beta2 receptor (found in bronchial smooth muscles, uterine muscles, blood vessel smooth muscles) and have little effect on beta receptors, on the heart muscle should have the effect of bronchodilator, reduce uterine contractions and have little effect on the heart.

Zencombi gives the simultaneous effects of 2 components of ipratropium bromid and salbutamol, which works on both Muscarinic and Beta 2 adrenergic receptors in the lungs, causing bronchodilator superior to single drugs and does not increase the undesirable effects of these drugs.

pharmacokinetics

salbutamol:

Bronchodilator effects appear after 2-3 minutes after inhaling the aerosol, up to 5 to 15 minutes and lasts 3-4 hours. The concentration of drugs in plasma is low, reaching maximum within 2-4 hours. About 72% of the inhaled pills excreted in the urine within 24 hours, of which 28% did not change and 44% had metabolized. Half -life elimination of the drug is 3.8 hours. Due to the low plasma concentration, the gas is less likely to cause side effects than tablets or injections.

Therefore, the type of aerosol can be used in patients with hyperthyroidism, arrhythmia, coronary circulation disorders, hypertension, diabetes, patients who are taking Monoamin oxydase inhibitors.

Bronchodilator appears about 3 minutes after spraying, hit medicine and lasts from 4 to 6 hours. The level of bronchodilator does not depend on the concentration of ipratropium bromid in plasma. Effects on nasal excretion appears 5 minutes after taking the drug to the maximum within 1 to 4 hours and lasts up to 8 hours.

Poor absorption drugs in the gastrointestinal tract; Do not pass through the blood - brain barrier. If you take or use the gastrointestinal medication, only 15-30% of the dose is absorbed. The amount of drugs absorbed in the bronchi is very small.

Selling time is about 3.5 hours. The drug is mainly eliminated through urine.

Before taking Zencombi CPC1HN controlled bronchospasm (10 vials x 2.5ml)

How to use

How to prepare drugs for aerosole sprayer when using ZencomBi solution via aerosator as follows:

1. Break a zencombi tube by turning a tube down and separating while holding the rest of the blister.

2. Keep one end of the Zencombi tube, rotate the body of the tube to open the lid.

3. Put the open end of the Zencombi tube into the cup of aerosol solution. Squeeze the Zencombi tube slowly to pour the drug solution into the cup. Pay attention to pour all Zencombi solution into the cup.

4. Prepare aerosol and use as directed.

5. After use, remove all the leftover solution in the cup of aerosator, then wipe off the aerosole sprayer as instructed in the machine.

Note: Masks, "T" masks can be used, or through the internal intubation to distribute the drug. It is possible to use interrupted positive pressure ventilation but rarely needed. It is necessary to breathe oxygen when there is a risk of hypoxemia due to ventilation. Due to many types of aerobic machine operating on the principle of continuous gas flow, the gas drug may be released into the surrounding environment. Therefore, it is advisable to use Zencombi, in the room with good ventilation, especially in the hospital when many patients use the aerospm at the same time.

Dosage

Zencom's dosage is recommended for adults (including elderly patients) as follows:

Acute attack treatment: 01 single -dose jar. In severe cases without cutting a second -dose single jar. In this case, the patient needs a doctor or go to the nearest hospital immediately.

Maintain treatment: 01 single -dose bottle x 3-4 times/day. Patients should see a doctor or go to the nearest hospital immediately in the case of difficulty breathing or severe shortness of breath if the dosage of Zencom is used for no improvement.

Instructions for use: Zencombi is used with aerosol or by a positive pressure ventilation as a doctor's instructions.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

Symptoms of ipratropium bromide overdose such as dry mouth, eye regulation disorders are mild and transient due to wide treatment scope and local use.

Overdose:

Using sleeping pills, sedatives, active treatment in severe cases.

The appropriate antagonistic drugs are the more appropriate beta receptor inhibitors rather than the selection on beta, but need to be cautious in patients with bronchial asthma.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

Zencombi's undesirable effect includes unwanted effects of salbutamol and ipratropium bromid:

Salbutamol's undesirable effect:

generally rarely encounter ADR when using doses of treatment.

Common, ADR> 1/100:

circulating: Brushing the chest drum, tachycardia.

Respiratory: bronchospasm, dry mouth, stimulating throat, cough and hoarseness. Ipratropium bromid:

Common, ADR> 1/100:

dry mouth, nose, throat is irritated.

Eye regulatory disorders.

urinary retention.

Rare, ADR

Body: Anaphylaxis. Narrow.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Zencom drugs contraindicated in the following cases:

Patients with a history of hypersensitivity to one of the ingredients of the drug.

Caution when using

may appear hypersensitivity reactions after using zencom with manifestation: urticaria, angioedema, rash, bronchospasm and pharyngeal edema.

Sore or uncomfortable in the eyes, blurred vision, vision, visual images that are tinted with red eyes due to conjunctival conjunctiva or corneal edema can be signs of narrow -angle glaucoma. If there is any combination of the above symptoms, it should be treated immediately with eye drops that cause pupils and consult a doctor. Patients must be properly instructed to use Zencombi, not to let the solution shot into the eyes. Patients with a history of narrow -angle glaucoma should be warned for eye protection.

Be cautious when used for patients in the following cases: Diabetes are not fully controlled, new patients with myocardial infarction, severe physical cardiovascular disorders, hyperthyroidism, adrenal marrow, narrow -angle glaucoma, prostate hypertrophy, bladder tumor.

Caution for patients with severe heart disease such as ischemia, tachycardia, severe heart failure. The active ingredient can cause positive results for doping tests in sports athletes. If the patient has a lot of sputum, it is necessary to be properly treated before taking the drug. Be careful when using salbutamol forms for pregnant women to treat bronchospasm because the drug affects uterine contractions especially in the first 3 months of pregnancy. When indicating Salbutamol, other beta stimulants need to be reduced if used.

The effect of the drug on the ability to drive and operate machinery

The drug can cause headaches, brush chest drums, fast heart rate, lower blood pressure, so be careful when used for driving patients, operating machinery.

Use drugs for women during pregnancy and lactation

pregnancy:

Salbutamol has been shown to cause teratogenic rats when subcutaneous injection at the corresponding dose is 15 times the dosage of aerosol in humans. There is no scale research in pregnant women. However, when used need to be careful to consider benefits.

ipratropium bromid: Although the experiment does not see the drug that has a teratogenic effect, it should not be used for patients in the first months of pregnancy.

breastfeeding period:

Do not know if the drug is excreted in breast milk, need to be cautious when taking the drug for nursing mothers.

Medicinal interaction

Take care of Xanthin's derivatives as well as other adrenergic beta drugs and anti -cholinergic drugs that can increase side effects. When used simultaneously with xanthin derivatives, glucocorticosteroids and diuretics can reduce blood potassium, so this possibility is especially in patients with severe respiratory obstruction.

Hemoto reduction can make patients using digoxin susceptible to arrhythmia, must monitor plasma concentrations for these cases.

When used simultaneously with beta inhibitors can reduce bronchodilator effect

Concentrated with Monoamine oxidase inhibitors or 3 -round antidepressants can stimulate Beta adrenergic. Inhaling Halogenized hydrocarbon anesthesia such as Halothan, Tricloroethylen and Enfluran may cause increased sensitivity to the effect on the cardiovascular system of Salbutamol.

Storage

Leave a cool place, avoid light, temperatures below 30⁰C.

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