This article is from "Nankai Sun Pharmacist", which is used for medical science popularization for reference. How to properly use budesonide formoterol powder inhaler?What to look out for?What is the difference between budesonide formoterol powder inhaler and salmeterol fluticasone powder inhaler?
Budesonide formoterol is a compound preparation composed of inhaled glucocorticoids and long-acting bronchodilators, which is the first control drug for bronchial asthma, budesonide is an inhaled glucocorticoid, which has local anti-inflammatory effects, can reduce airway inflammation, improve asthma symptoms, prevent asthma attacks, and has few systemic adverse reactions with topical medication. Formoterol is a long-acting bronchodilator, which can relax bronchial smooth muscles and dilate bronchi, thereby relieving symptoms of shortness of breath and wheezing, and can be maintained for at least 12 hours with a single effect, and has a certain anti-inflammatory effect, which can effectively inhibit the release of allergic mediators, and is an effective drug for asthma.
Budesonide formoterol powder inhaler is a dry powder inhaler, with a special inhalation device, called "Dubao", only the correct use of the inhalation device, in order to ensure that the drug reaches the bronchi and lungs, fully effective, today Sun Pharmacist will introduce you to the correct use of budesonide formoterol powder inhaler, referred to as the "seven-step method":
Step 1 (Open the device): Hold the bottle vertically, making sure the red screw is underneath, rotate and open the cap.
Step 2 (Loading): When the red screw at the bottom of the device is rotated to the point where it can no longer be rotated, turn back to the original position in the opposite direction until you hear a "click" sound, indicating that the 1st dose of powder has been loaded.
Step 3 (Exhale): Exhale gently until there is no more air to exhale from your lungs, taking care not to exhale into the mouthpiece.
Step 4 (Wrap the nozzle): Place the device nozzle between the upper and lower teeth and wrap the nozzle with your lips.
Step 5 (Inhalation of the Medicine): Inhale hard and deeply.
Step 6 (Breath Hold): Remove the nozzle from your mouth, hold your breath for 5 seconds, and then exhale normally.
Step 7 (Closing the Device): Screw the lid tightly.
Long-term use of budesonide formoterol powder inhalers requires attention:
1.Budesonide formoterol powder inhalation is a topical drug, systemic adverse reactions are rare, budesonide can cause a decrease in respiratory immunity locally, common hoarseness, dysphonia, oropharyngeal candida infection and other local adverse reactions, at least 3 times after deep gargling, can effectively prevent or alleviate local adverse reactions.
2.Budesonide formoterol powder inhalation is usually given for 3 months, and then the doctor evaluates and decides whether to continue the medication.
3.Budesonide formoterol powder inhalation device is twisted to the left or right, as long as you hear a "click" sound, it means that the drug is completed and you don't have to screw it back, if you don't hear a "click" sound, you need to screw it back again.
4.Long-term use of budesonide formoterol powder inhaler, glucocorticoid receptors are occupied for a long time, sensitivity is reduced, and it is easy to produce hormone dependence, and sudden discontinuation of the drug can lead to asthma attacks, therefore, for patients who have been using budesonide formoterol powder inhaler for a long time, the dose should be gradually reduced when discontinuing the drug to avoid sudden discontinuation.
5.There is a small window on the bottle of budesonide formoterol powder inhaler, if the window is partially red, it means that there are about 10 more inhaled doses, and if it turns red completely, it means that the dose has been used up.
6.Long-term use of budesonide formoterol powder inhalation can cause systemic adverse reactions such as palpitations, skeletal muscle tremor, hypokalemia, and hyperglycemia, and it is recommended to regularly monitor serum potassium and blood glucose during medication.
Budesonide formoterol powder inhaler differs from salmeterol fluticasone powder inhaler in that:
1. Inhalation device: The inhalation device of budesonide formoterol is called "Dubao", the inhalation device of salmeterol fluticasone is called "Zhunan", "Dubao" is long, "Zhunan" is round, "Zhunan" has a counting window, and every time you inhale, the number of inhalations on the window will be reduced once, so that the patient can clearly know the number of inhalations and the remaining times, and improve medication compliance. The inspiratory resistance is larger, more laborious, not suitable for the elderly and children, the inspiratory resistance of the "quasi-admittance" is smaller, **more labor-saving, suitable for the elderly over 70 years old and children under 4 years old, the lactose content in the "Dubao" is low, **no feeling, I don't know whether to suck it in, the medication experience and compliance are not good, the lactose content in the "quasi-admittance" is higher, **there is a sweet feeling, increase the patient's self-confidence, and improve medication compliance.
2.Efficacy: Compared with budesonide, fluticasone has better lipophilicity, stronger affinity with glucocorticoid receptors in the airways, and the anti-inflammatory effect is the strongest among all inhaled glucocorticoids, and the action time is long, the local selectivity is good, and the whole body is less. The advantage of budesonide is that it has a fast onset of action and is suitable for pregnant and lactating women. Formoterol is moderately hydrophilic and lipophilic, can be effective in 3 minutes, similar to albuterol, can be used in first aid in acute attacks of bronchial asthma and COPD, salmeterol takes at least 30 minutes to take effect, is not suitable for first aid, and should be carried with salbuterol.
3.Clinical evidence: For patients with bronchial asthma, there was no significant difference in the effect of budesonide formoterol and salmeterol fluticasone on asthma exacerbations when the time was less than 6 months, and budesonide formoterol had a lower chance of exacerbation than salmeterol fluticasone when the time was less than 6 months, i.e., budesonide formoterol was more effective in asthma control. In patients with COPD, budesonide formoterol reduces the risk and frequency of exacerbations, reduces the use of albuterol, and effectively improves lung function compared with salmeterol fluticasone. For patients with poorly controlled asthma with salmeterol fluticasone, switching to budesonide formoterol can achieve better clinical results.