Otitis

Combination therapy of bronchial obstruction in children. Obstructive bronchitis in adults: treatment with traditional and folk remedies These medications include

Bronchitis is a serious disease that requires well-chosen and timely treatment. It is extremely important to know which medications for bronchitis will be most effective and which ones should be avoided.

Anti-inflammatory drugs

The main role in the treatment of bronchitis is played by anti-inflammatory drugs aimed at reducing pain, eliminating fever and relieving the resulting inflammatory process.

The most popular anti-inflammatory drugs in the treatment of bronchitis are:

Paracetamol, which is intended to relieve fever and painful syndromes. It can be used both in the form of tablets and suspension. The maximum dose of the drug per day should not exceed 4 grams, and a single dose should not exceed one gram. Taking paracetamol is not recommended during pregnancy, as it easily crosses the placental barrier.

Prednisolone is one of the most effective anti-inflammatory drugs that has the ability to slow down the development of inflammation. However, due to the high risk of complications and side effects, it should be taken only under the strict supervision of doctors. Prednisolone tablets are prescribed and monitored only by a doctor after conducting a series of tests. The daily dosage of prednisolone should not exceed 200 mg.

Sinupret is a herbal medicine that is available both in the form of tablets and drops. The anti-inflammatory effect is based on the biologically active components that are included in its composition. It also has a restorative effect on the mucous membranes of the respiratory tract and promotes the removal of viscous secretions from the body. Sinupret is most effective when combined with antibacterial tablets.

The dosage of Sinupret is prescribed individually, but it should not exceed 6 tablets or 150 drops per day.

Erespal are tablets that have anti-inflammatory and antibronchoconstrictor (bronchodilator) effects. It can be prescribed both in the presence of chronic respiratory failure and without it. Drinking Erespal is recommended to inhibit the growth of substances that affect the development of bronchospasm.

The daily dosage of Erespal should be no more than 240 milligrams.

Antibiotics

Antibiotic therapy for bronchitis is prescribed to adults only in the presence of a bacterial infection confirmed by appropriate tests. In all other cases and forms of this disease there is no need to take antibiotics. To determine the optimal antibiotic for treatment, research is required to determine the type of pathogenic microorganisms that cause bronchitis. For the most effective treatment, droppers may be prescribed.

Among the effective drugs related to antibiotics, it is worth noting Macropen. It is successfully used to treat children and adults. The action of this drug is based on inhibition or disruption of protein synthesis in bacterial cells, which certainly leads to their death.

A distinctive feature of Macropen is the rare occurrence of allergic reactions and intestinal problems. The dosage of the medicine should be prescribed by a doctor after studying the tests. But its daily intake should not exceed 1.6 grams.

Bronchodilators: what are they and when to take them?

If during the course of bronchitis there is a problem with bronchial patency, the so-called obstruction, then it is necessary to take bronchodilators. The most effective forms of drugs in this group include solutions for use in inhalers and nebulizers, which allow the medicine to be delivered directly to the damaged area of the lungs. Bronchodilators eliminate bronchospasm and also increase the tone of the bronchial muscles.

Among the most effective drugs are:

Eufillin, which is available in tablet form and provides relaxation of the bronchial muscles, and also acts as a stimulator of contractions of the diaphragm. Taking aminophylline is accompanied by improved activity of the intercostal and respiratory muscles, and improved ventilation of the alveoli. You need to drink aminophylline after meals, 150 milligrams 1-3 times a day.
Ventolin is more often used for chronic bronchitis. Due to the fact that the drug is released in the form of an aerosol inhaler, it quickly reaches the sites of the disease and relieves bronchospasm. This leads to a decrease in resistance in the lungs, which is accompanied by easier breathing. Ventolin also provokes mucus secretion. The effect after inhalation occurs after five minutes, and the most pronounced effect is observed after half an hour. The dosage of Ventolin should not exceed 200 mcg/day.

Salbutamol is an effective aerosol that can significantly relieve bronchospasm and also reduce lung resistance. While taking the drug, an increase in the vital capacity of the lungs is observed. Has a long lasting positive effect. The aerosol dosage is prescribed based on individual needs. Salbutamol is also available in tablet form and in this form can be prescribed to both adults and children.

Mucolytic drugs

An integral part of the treatment of bronchitis are mucolytic drugs. They help liquefy and remove mucus, which speeds up the healing process.

The following drugs are mainly prescribed:

Bromhexine, which is available in the form of solution, syrup and tablets. It has not only a mucolytic effect, but also an expectorant. Drinking Bromhexine is necessary to dilute bronchial secretions, which facilitates its rapid removal. The maximum dose of Bromhexine in tablet form should not exceed 64 mg/day, and in the form of inhalation - no more than 16 mg/day.
Ambrobene is one of the most effective mucolytic drugs, the main active drug of which is ambroxol. It has secretolytic, expectorant and secretomotor effects. The effect of taking Ambrobene occurs half an hour after administration, and its duration ranges from 6 to 12 hours. It is not recommended to drink Ambrobene together with antitussive medications, as this may cause sputum stagnation.

The greatest therapeutic effect of Ambrobene is manifested in the case of abundant fluid intake into the body, so its intake should be accompanied by plenty of drinking.

The dosage of the drug is prescribed based on personal characteristics, but it should not exceed 120 mg/day.

Lazolvan. It is based on ambroxol and has a pronounced mucolytic character. The drug perfectly stimulates mucus transport, which significantly improves sputum discharge and eases coughing attacks. It is not recommended to take Lazolvan together with antitussive tablets, as this will make it difficult to remove sputum. You can drink it 3 times a day, 1 tablet, or for a more pronounced effect - 2 times a day, 2 tablets.
ACC is an effective mucolytic drug that is effectively used even for chronic and purulent bronchitis. The composition of ACC helps reduce the viscosity of sputum, which facilitates its rapid removal. It is recommended to drink ACC after meals, and it is also advisable to drink plenty of fluids, which enhances the effect of the drug. The medicine should not be taken together with antitussive drugs. The dosage of ACC is prescribed individually and depending on the selected modification of this medicine.

Complementary therapy

The initial stage of bronchitis is characterized by a dry, suffocating cough, which is not productive, but greatly exhausts the patient. To alleviate this condition, it is recommended to take antitussive medications. It is worth emphasizing that taking such medications is necessary only during a dry cough. If a wet cough appears, you should immediately stop taking antitussives, as they will provoke stagnation of sputum.

One of the popular antitussive drugs is Sinekod, which has nothing to do with opium alkaloids. When taken, there is a direct effect of the drug on the cough center. Sinekod should be taken before meals; its dosage is 25 drops four times a day.

To treat bronchitis with pronounced obstructions or its allergic form, antihistamines are used.

They are used to inhibit the inflammatory process, blocking histamine, which can cause muscle spasms and poor circulation. Antihistamines also have a pronounced anti-edematous effect. To date, several generations of antihistamines are known. 3rd and 4th generation medications are considered safe for health, as they cause minimal side effects. Antihistamines are prescribed if you have a dry cough. They can be taken as tablets, droppers, or sprays.

When carrying out any therapy using medications, calcium is washed out of the body. Calcium gluconate injections can be used to replenish this important element. It also has a positive effect on the contraction of smooth muscles and the transmission of nerve impulses. Among the actions of calcium gluconate, there is a decrease in vascular permeability, which is important for eliminating allergic reactions. Calcium gluconate is actively used in the treatment of inflammatory diseases and especially often in bronchitis.

Any medications should be taken only as prescribed by the attending physician.

It is he who will select the required dosage and designate the treatment regimen. Do not forget that vitamins are useful for bronchitis, as well as for other colds. They will help restore the required amount of trace elements and minerals in the patient’s body.

What injections are prescribed for children with bronchitis Prevention methods Advice from a pediatrician

Do you know enough about injection treatment?

Injections for the treatment of bronchitis are prescribed extremely rarely, only in severe cases. Or when the patient cannot, for some reason, take the medicine in tablet form. All modern drugs prescribed for bronchitis are available both in powders for injection and in tablet form. Therefore, the treatment method must be selected by the doctor for each patient individually.

There are some indications for prescribing injections:

infancy (such a child cannot be given a tablet, and in some cases, syrup)

exacerbation of chronic bronchitis

severe respiratory obstruction

obstructive bronchitis in a small child

lack of positive results for 3-4 days when treating adult patients.

Antibiotics: necessary or not?

Bronchitis in most cases is viral in nature, so injecting antibiotics is pointless. But there are times when you can’t do without them in such situations:

treatment of adults over 60 years of age (the body does not have enough strength to fight the disease, so antibiotic injections become a necessity)

infancy (the infant’s immunity is not yet formed and cannot cope with the disease, there is a risk of missing a concomitant infection, which can lead to serious complications)

severe forms of bronchial obstruction

chronic obstructive bronchitis (there is a high probability of developing bacterial complications due to the fact that the bronchi are weakened by the disease).

Before taking antibacterial drugs in injections, it is necessary to conduct a sensitivity test.

Medicines. administered by injection, they quickly enter the bloodstream and begin to act on the body, so in case of an allergy, the reaction will be immediate. To treat bronchitis, doctors can prescribe injections of sulfonamide antibiotics and Trimethoprim. They are combination drugs, sensitivity to which is not often detected in children and adults, resistance develops slowly, and complications are also rare.

As for side effects, skin rashes and fungal infections of the oral cavity can sometimes be observed. Drugs of this group, which are used in the treatment of adults and children, are Sinersul, Groseptol, Bactrim and others.

Semi-synthetic broad-spectrum antibiotics are also used. These are Ampicillin, Amoxiclav, Ospamox, Hiconcil. If the medications listed above are ineffective, then gentamicin injections are prescribed. It is effective for mixed or bacterial infections in patients with weakened immune systems.

Only a doctor should decide whether to take antibiotics to treat bronchitis.

You cannot prescribe medications on your own, especially with injections. The injection method of administering the medicine is more dangerous due to the risk of injecting incorrectly and the likelihood of an allergic reaction. The consequences of self-medication of adults and children with antibiotics can be unexpected.

How to overcome severe form?

Glucocorticosteroids are prescribed when traditional treatment of bronchitis in adults has not produced any results, and even with an increase in the dosage of conventional drugs, no positive changes in the patient’s condition are observed. In this case, injections of prednisolone (which is what is most often prescribed) can help overcome obstructive bronchitis.

Prednisolone has severe side effects (diabetes, gastric ulcer, myopathy, osteoporosis).

The dosage of glucocorticosteroids must be reduced gradually, which will help prevent the development of an undesirable reaction of the body. An alternative to Prednisolone can be Decortin, Sol-Decortin or Medopred. Adults are treated with glucocorticosteroids extremely rarely and only in exceptional cases.

Symptomatic treatment

Bronchodilators belong to the category of symptomatic drugs that are indicated for chronic bronchitis in adults, airway obstruction syndrome and bronchospasm (difficulty breathing, shortness of breath). Injecting bronchodilators is necessary in cases where it is necessary to urgently dilate the bronchi.

Uncontrolled use of bronchodilators can provoke undesirable serious consequences. These medications allow you to expand the gap between the walls of the bronchi and help clear the lungs of mucus, which makes breathing easier for the patient. However, they have a number of side effects, for example, nervousness, sleep problems, and rapid heartbeat.

Treatment for bronchitis should include drug therapy, but it should be selected exclusively by a doctor.

Children and adults are often prescribed drugs in tablet form. which, under special indications, can be introduced into the patient’s body by injection. Through injections, the medicine enters the bloodstream much faster than tablets, so they must be taken under medical supervision. The selection of drugs and dosage are made taking into account the characteristics of the patient’s body and the course of the disease.

Injections for bronchitis

Antibiotic injections for bronchitis

As you know, bronchitis is an inflammation of the human bronchi. This process is not easy, with thickening of the mucous membrane of the upper respiratory tract. Accordingly, it becomes difficult for the patient to breathe, he experiences shortness of breath and possible attacks of suffocation. Bronchitis must be treated immediately; this must be done in order to prevent the acute form from becoming chronic. The acute form of the disease is easier to cope with, but in any case, injections are prescribed for bronchitis. Before practicing intramuscular injection of medication, be sure to consult with your doctor - not only regarding the injection technique, but also, most importantly, ask him what kind of injections you should give for bronchitis.

Basically, these can be the following injections: antibiotics for bronchitis and enzymes, which, in principle, can be taken in the form of tablets (for example, mucaltin) and tinctures, decoctions or elixirs of medicinal herbs. Doctors may prescribe intravenous benzylpennicillin (possibly with the addition of streptomycin). When treating chronic bronchitis, levomecithin is injected in most cases. The effectiveness and duration of treatment must be determined by the doctor. However, you can support your body in resisting the disease.

Since very often bronchitis develops in parallel with respiratory tract infections, which are accompanied by a sore throat, use Florenta spray from Argo. The drug is developed on the basis of natural ingredients and has only a positive effect on the patient’s immunity and health in general. Its effectiveness has been proven by European scientists, so you can experience the rapid antiseptic and analgesic effect of Florent spray by your own example. To support your child’s body, purchase the Fo Kidz phytoformula - this is an ideal way to saturate the child’s body with essential vitamins and microelements, much-needed iodine and folic acid, as well as increase the body’s resistance to infections and improve the concentration and performance of your baby’s brain.

The use of injections in the treatment of bronchitis

Sometimes traditional treatment methods go by the wayside and injections are prescribed for bronchitis. This treatment method is not very popular, but sometimes there is no other option.

Prerequisites for prescribing injections

Unfortunately, sometimes, for one reason or another, bronchitis can be quite severe. In addition, it may not be possible to treat a cough with tablets and syrups. To carry out full treatment, injections are prescribed in the following cases:

Infancy. For obvious reasons, young children cannot administer medications by mouth on their own. When diagnosing bronchitis, you have to give injections.
Old age, when the body does not fight infection well on its own.
Unconscious state of the patient.
Particularly difficult cases of the disease.
The presence of rapidly developing complications.

Injections are prescribed only under the strict supervision of the attending physician. It is undesirable to decide to inject a person on your own, especially without medical education. In addition, this method of treatment is usually resorted to in extreme cases, without alternatives.

Injections for bronchitis and their types

Most often, based on statistical data, patients are prescribed antibiotics in the form of injections. This is done mainly in severe cases in order to respond as quickly as possible to the deterioration of the condition. Antibiotics also most often become a barrier to the development of pneumonia and other bacterial complications in the respiratory system. Quickly entering the blood, they help fight bacteria and, as a rule, lead to a quick recovery.

Antibiotics include broad-spectrum drugs. This could be penicillin, etc. If the immune system is suppressed and symptoms rapidly progress, azithromycin can also be prescribed.

In addition to medications, so-called bronchodilators are also popular. These are largely symptomatic remedies that are publicly available in the form of both oral medications and injections. Drugs in this group include isadrin and inoline. They are used to get rid of painful coughing attacks and to open the brochial passages, freeing them from phlegm. Often, during recovery, they are used along with syrups and tablets.

Sometimes even strict antibacterial therapy for bronchitis does not lead to the desired recovery. In some such cases, it is common to use hormonal therapy. These may be drugs Medopred, Decortin for intramuscular administration. However, it is worth noting that such therapy is used only in extreme cases of bronchitis. This is due to the fact that a number of serious complications may occur, such as, for example, diabetes mellitus, stomach and duodenal ulcers.

In case of bronchitis, it is necessary to make timely decisions to choose treatment methods.

Only a doctor can prescribe intramuscular administration of drugs if there are no alternatives.

The patient must understand that glucocorticosteroid treatment, like antibiotic therapy, can cause damage to the body.

Injections for bronchitis

Bronchitis is a disease characterized by inflammation of the bronchi. During illness, the mucous membrane of the upper respiratory tract thickens. Because of this, a person with bronchitis cannot breathe normally and begins to suffer from attacks of suffocation. Injections for bronchitis should be prescribed only by a professional doctor after conducting the examination necessary in this case.

1. What kind of medicine needs to be injected for bronchitis, and with what regularity, only the doctor decides.

2. As a rule, antibiotics are prescribed along with tablets (Mukaltin) and decoctions of medicinal herbs.

3. Most often, intravenous injections of the drug benzylpennicillin are prescribed for bronchitis. In some cases, the drug streptomycin is added to it. If this unpleasant disease has become chronic, it is necessary to give injections of chloramphenicol.

When treating bronchitis, you should not rely only on the effectiveness of injections. Do not neglect valuable and useful medical recommendations and use all the ways to help you cope with the disease faster. Often, people suffering from bronchitis are advised to quit smoking, drink plenty of warm fluids and take herbal decoctions.

Side effects and use of the drug Prednisolone

Prednisolone is a synthetic hormonal drug that has a pronounced anti-inflammatory effect. This remedy can relieve unpleasant symptoms after just 2 days; it would seem that this is a panacea for all diseases.

But there are many controversies and debates regarding its use citing the side effects caused by this medicine. In this article we will tell you why Prednisolone is taken, how it works, whether it is prescribed to children and pregnant women, what are the contraindications of the drug, and why it is dangerous.

Properties, action and use of the drug

If the drug is taken for a long time, the activity of fibroblasts is inhibited, the union of not only collagen, but also connective tissue is reduced, protein in the muscles is destroyed, and protein synthesis in the liver increases.

Due to inhibition of lymphocyte growth, long-term use suppresses the production of antibodies, which has a positive effect on immunosuppressive and antiallergic properties.

Due to the influence of the drug, the reaction of blood vessels to the vasoconstrictor substance increases, because of this, vascular receptors become more sensitive, the removal of salt and water from the body is stimulated, which affects the anti-shock effect of the drug.

In the liver, protein synthesis is stimulated, the stability of the cell membrane increases, which leads to a good antitoxic effect.

Taking Prednisolone increases the synthesis of glucose by the liver. Elevated blood glucose levels increase insulin production.

Prednisolone has the following effects:

It is important to take this remedy correctly, due to indiscriminate use, fat accumulation is observed, calcium absorption by the intestines is impaired, and its leaching from the bones and excretion by the kidneys increases. A high dosage of the drug increases the excitability of the brain, reduces the threshold of convulsive readiness, and stimulates increased secretion of hydrochloric acid and pepsin by the stomach.

Many people are interested in the question of how long the drug lasts. Medicines available in tablets naturally take longer to take effect. The tablets have 2 types of dosage: 1 and 5 mg.

The action of Prednisolone begins from the moment it enters the circulatory system from the gastrointestinal tract and forms a bond with proteins. If the blood contains less protein, then Prednisolone has a negative effect on the body as a whole, therefore, when treating with this drug, regular blood monitoring is necessary.

On average, the drug has an active effect 1.5 hours after its use, which continues throughout the day, after which it decomposes in the liver and is excreted by the kidneys and intestines. Prednisolone injections when administered intramuscularly begin to act after 15 minutes, when administered intravenously - within 3-5 minutes.

In tablets

The medicine in tablet form is effective for the following conditions:

Prednisolone helps with severe allergic diseases, such as:

Bronchitis.
Bronchial asthma.
Eczema.
Anaphylactic shock.

Prednisolone is taken for diseases that are associated with low production of corticosteroids, for example:

Adrenal gland dysfunction.
Addison's disease.
Adrenogenital syndrome.

Somatic indications for taking this drug:

In injections

Indications for the administration of Prednisolone injections are associated with severe conditions that require urgent care. Injections are administered both intramuscularly and intravenously for the following conditions:

Brain swelling.
State of shock.
Adrenal insufficiency.
Toxic crisis.
Swelling of the larynx.
Poisoning.

Local application

Indications for local use are as follows:

It is correct to use Prednisolone during pregnancy only in cases where the need for use for a woman is higher than the possible risk for the baby. This drug passes through the placental barrier and has an effect on the fetus, and the dosage is selected individually based on the patient’s condition.

Indications for prescribing Prednisolone for bronchitis

Prednisolone helps well with chronic bronchitis, which is complicated by obstruction. Of course, this drug is a serious drug, but when bronchodilator therapy does not have an effect, this drug is prescribed in tablets against the background of ongoing treatment with bronchodilator drugs.

For chronic bronchitis, aggravated by elevated temperature, Prednisolone is used for quite a long time. Only then can you count on a successful result.

Many people are afraid to use this drug; of course, this is a serious medicine, but with its help you can quickly remove the obstruction and return to your normal lifestyle.

Dosage, side effects and contraindications of Prednisolone

However, it is important to drink most of it in the morning. To ensure that side effects have minimal impact on the gastrointestinal tract, you need to take the tablets during meals with a small amount of water. The following recommendations must be followed:

In special cases, a dosage of 15 to 100 mg may be needed for initial treatment, and from 5 to 15 mg daily for maintenance of the body;

For children, the dosage is calculated individually, based on the child’s weight, and it is divided into 4-6 doses. The initial dose is from 1 to 2 mg per 1 kg of weight, maintaining from 300 to 600 mcg per 1 kg. As soon as you feel better, the therapeutic dosage of Prednisolone is reduced to 5 mg, then to 2.5 mg.

The intervals between dose reductions should be no more than 3 days; if the drug has been used for a long time, then the daily dose should be reduced more slowly.

Prednisolone therapy should not be abruptly stopped; withdrawal should occur more slowly than its prescription.

If during therapy with this drug there is an exacerbation of the disease, an allergic manifestation, surgery, or stress, then the dosage of the drug must be increased 2-3 times, namely:

In critical situations, the injection can be repeated after half an hour.

Prednisolone eye drops are instilled for adults, 2 drops three times, for children, 1 drop. Local application of the ointment is possible 1 to 3 times in a thin layer on the damaged area of the skin.

Prednisolone, like all medications, has contraindications for its use, namely:

The drug has an effective effect on the body as a whole, but it is combined with a considerable number of undesirable effects. Below we consider the most well-known side effects that affect many systems.

Endocrine system

This drug causes disorders of the endocrine gland, manifested in the form of destruction of proteins that are used to produce glucose by the body, this has a negative effect on metabolic processes. Long-term use of Prednisolone leads to a lack of protein in the blood. Due to which the body produces harmful progesterone.

If there is a lack of protein in the plasma, then growth disturbances and failure of sexual development occur in children.

Against the background of endocrine system disorders, blood sugar levels rise, which naturally has a negative effect on people with diabetes. At the same time, fats are formed and deposited in the tissues, which leads to excess weight.

There is a violation of the mineral balance, there is an excessive withdrawal of calcium and potassium, resulting in the accumulation of salts and water. All this leads to the formation of edema and thinning of the bones. If you take Prednisolone for a long time, women experience disruption of the menstrual cycle, and men experience sexual dysfunction.

Of cardio-vascular system

Disorders of the cardiovascular system. Due to the removal of potassium from the body, the myocardium often suffers, which leads to an abnormal heart rhythm. A too slow rhythm may develop, leading to cardiac arrest, heart failure develops, and blood stagnation forms in the vessels. The situation is made worse by the retention of water and sodium in the body, which leads to the formation of more blood volume and increased stagnation.

Nervous system

Often, while taking this drug, there is a disturbance in the nervous system, which leads to increased blood pressure and vasospasm. All this causes blood clots - the main cause of strokes and heart attacks. Therefore, in people suffering from a heart attack, tissue scarring occurs slowly.

Side effects from the nervous system affect spasms of blood vessels, stagnation of blood vessels, which leads to headaches, increased brain pressure, insomnia, convulsions, and dizziness.

Prednisolone is a drug from the group of glucocorticoids and is an analogue of hydrocortisone. Has an impact at the system level. Prescribed for bronchial asthma and other diseases that require a rapid increase in the level of adrenal hormones in the blood.

Effect of the drug on allergies and inflammation

It has an effect in the following ways:

Prevents the destruction of lysosome membranes and the release of proteolytic enzymes. Thus, when tissue is damaged, pro-inflammatory proteolytic enzymes remain in lysosomes.
Reduces vascular permeability, prevents the outflow of blood plasma into tissues. The drug prevents the development of edema.
Inhibits the migration of leukocytes to the site of inflammation and phagocytosis of damaged cells.
It has an immunosuppressive effect, reducing the formation of lymphocytes and eosinophils. Large doses cause involution of lymphoid tissue.
Reduces fever by suppressing the release of interleukin-1 from leukocytes, which activates the hypothalamic thermoregulation center.
Suppresses the formation of antibodies.
Inhibits the reaction of interaction of foreign proteins with antibodies.
Inhibits the release of allergy mediators from basophils and mastocytes.
Reduces tissue sensitivity to histamine and other biologically active substances that have a pro-inflammatory effect.
Suppresses the biosynthesis of prostaglandins, interleukin-1, tumor necrosis factor.
Reduces the viscosity of mucus in the bronchi.
Increases the affinity of beta-adrenergic receptors of the bronchial tree for catecholamines, resulting in increased blood pressure.

Prednisolone suppresses allergic reactions and inflammation.

Under its influence, scarring of connective tissue slows down. Glucocorticoids stimulate the formation of red blood cells in the red bone marrow. Their long-term use can cause polycythemia.

Effect on metabolism

At the systemic level, the drug affects the metabolism of carbohydrates, lipids and proteins. In liver cells, the number of enzymes necessary for the formation of glucose from amino acids and other substances increases. Due to the stimulation of gluconeogenesis, a glycogen reserve is formed in the liver. The level of glucose in the blood increases, while the consumption of carbohydrates by cells decreases. An increase in blood sugar levels triggers the synthesis of insulin by pancreatic cells. Tissue sensitivity to insulin decreases under the influence of glucocorticoids.

Hormones of the adrenal cortex reduce the concentration of amino acids in all cells of the body except hepatocytes. At the same time, the level of globulin proteins and amino acids in the blood plasma increases, the level of albumin decreases. Intense breakdown of proteins occurs in tissues. The released amino acids enter the liver, where they are used for the synthesis of glucose.

Prednisolone stimulates lipid catabolism. The concentration of free fatty acids in the blood plasma increases, they are used as a source of energy. The drug reduces the excretion of water and sodium from the body, increases the excretion of potassium. Reduces calcium absorption in the gastrointestinal tract and bone mineralization.

Long-term use of Prednisolone reduces the synthesis of corticotropin by the adenohypophysis, as a result of which the formation of endogenous glucocorticoids by the adrenal cortex decreases.

Forms of release of the drug

Produced in the form:

tablets of 1 and 5 mg,
injection solution containing 15 and 3 mg of active substance,
ointments for external use,
eye drops.

The drug has a systemic effect only when administered by injection or orally. Injections can be either intravenous or intramuscular.

Prednisolone for bronchial asthma

When choosing a basic therapy drug, the doctor must take into account the severity of asthma and the presence of complications. The age and body weight of the patient also matters. Prednisolone is prescribed for severe forms of the disease when inhaled corticosteroids do not have a therapeutic effect.

In the first days of treatment, it is recommended to take up to 60 mg of the drug per day, gradually reducing the dose of the drug. The duration of the course varies from 3 to 16 days. The withdrawal of systemic glucocorticoids should be gradual to avoid the development of hypofunction of the adrenal cortex.

The optimal time of administration is the morning, which is associated with the natural rhythms of the functioning of the endocrine system. The tablets should be taken once a day, but when very large doses are prescribed, split doses are possible. Some doctors believe that the maximum effect of Prednisolone is achieved when the drug is administered in the middle of the day. A maintenance dose of medication can be taken every other day.

Prednisolone for asthma is combined with long-acting β 2 -adrenergic agonists, bronchodilators, and nonsteroidal anti-inflammatory drugs. To mitigate side effects, it is recommended to increase potassium intake with food or medications while taking Prednisolone.

For other diseases of the respiratory system

Prednisolone is used not only to treat bronchial asthma, but also for the following diseases of the respiratory system:

acute alveolitis,
sarcoidosis,
tuberculosis,
aspiration pneumonia,
lung cancer,
purulent sore throat,
allergic bronchitis.

For cancer, Prednisolone complements surgical removal of the tumor, taking cytostatics and radiation. To treat tuberculosis, glucocorticoids are prescribed in conjunction with chemotherapy. For angina, the use of Prednisolone and other hormonal drugs is indicated only in combination with antibiotics. Glucocorticoids reduce inflammation and reduce fever, but do not suppress the activity of pathogenic microflora.

Prednisolone for bronchitis is used if the disease has an allergic etiology and is complicated by obstruction.

Contraindications

An absolute contraindication for taking the drug is individual intolerance to the active substance or auxiliary components. The medicine is used with caution when:

Taking corticosteroids by a pregnant woman can cause adrenal hypofunction and growth impairment in the fetus. It is undesirable to use Prednisolone before and after vaccination, since the drug suppresses the immune response.

Side effects

The most common side effects during treatment:

obesity with the deposition of excess fat on the face and in the cervical-collar area,
increased blood glucose levels,
arterial hypertension,
arrhythmias,
bradycardia,
thrombosis,
disorders of the digestive system,
neuroses,
psychical deviations,
swelling,
delayed scar formation,
manifestations of allergies,
exacerbation of chronic infectious diseases.

Compared to other systemic hormonal drugs, Prednisolone has a weak mineralocorticoid effect and a mild effect on skeletal muscles.

What drugs can be replaced

For bronchial asthma, the following systemic glucocorticoids can be used:

methylprednisolone,
dexamethasone,
betamethasone,
triamcinolone.

Despite the similarity of effects on the body, the listed drugs cannot be considered complete analogues. They differ in metabolic rate, severity of therapeutic effect and side effects.

Methylprednisolone and Prednisolone differ from other drugs in their faster elimination from the body. Methylprednisolone has a slight effect on appetite and psyche, and therefore is more often prescribed to patients with excess weight and mental disorders.

Triamcinolone is a drug with an intermediate duration of action. Causes side effects on the skin and muscles, and therefore its long-term use is undesirable.

Dexamethasone and betamethasone are long-acting drugs. Dexamethasone for asthma is prescribed if the patient suffers from a severe form of the disease, turning into status asthmaticus. The drug has more pronounced glucocorticoid activity than Prednisolone, but does not affect water-electrolyte metabolism.

The number of patients suffering from this severe respiratory disease is rapidly increasing. As WHO predicts, obstructive bronchitis will soon become the second cause of death in the world, ahead of cancer, heart attacks and strokes.

Drug treatment of obstructive bronchitis

What is obstructive bronchitis and how to treat it? There are many reasons why the lower respiratory tract becomes irritated and inflamed: harmful chemicals in the air, dust, plant secretions, bacterial, viral infection. The lumens of the bronchi and their small branches of the bronchioles swell and narrow. The accumulating phlegm, unable to find a way out, stagnates. As a result, a person has difficulty breathing and is overcome by attacks of suffocation.

However, this is not so bad. Obstruction (muscle spasms) triggers a dangerous mechanism of degradation of the bronchial tree. Gradually, the pathological process becomes almost irreversible. Obstructive bronchitis is a disease typical of adults. Children are characterized by prolonged acute inflammation of the lower respiratory tract, especially if the child has weak immunity.

Often the disease occurs against the background of rhinitis, sinusitis, pharyngitis, and tonsillitis. Treatment of chronic obstructive bronchitis in adults does not require relief of symptoms, not episodic therapy, but patient comprehensive sanitation of the entire respiratory system, which can take more than one month. Only under this condition does the serious disease stop progressing.

Treatment is distinguished by a variety of schemes, which take into account the stages of the disease and the degree of destruction of the respiratory organs. No medicine will bring the desired effect if a person continues to smoke. As soon as the patient gives up nicotine, the condition of his bronchi improves significantly, even in heavy smokers with advanced forms of the disease.

Bronchodilators

These are bronchodilators, bronchodilators, as pharmacists and doctors call such medications. Medicines with different mechanisms of action are combined into a single group, since their general purpose is to eliminate spasms of diseased bronchi. To cure a patient diagnosed with obstructive bronchitis, such a basic drug is urgently needed. Spasms quickly pass as soon as the bronchi expand.

Anticholinergics

Basic medications for relieving bronchospasm attacks:

Atrovent (ipratropium bromide) is an aerosol and solution for inhalation, acting quickly, after 10-15 minutes, but not for long, about 5 hours;
Berodual (ipratropium bromide plus Fenoterol) – also short-acting;
Spiriva (tiotropium bromide) is a long-acting inhalation powder.

Beta-agonists

The effect of short-acting medications occurs in a matter of minutes and lasts about 5 hours. They can treat obstructive bronchitis with acute bronchospasm attacks. The most famous:

Salbutamol - an aerosol for inhalation with a dispenser (injection solution and tablets are less in demand), an ambulance for asthmatic attacks;
Fenoterol tablets are more effective than Salbutamol;
Ipradol (Hexoprenaline) – dosed aerosol.

The effect of long-acting medications occurs in about 15 minutes, but lasts twice as long, about 10-12 hours:

Clenbuterol is a syrup that can be used for treatment after the first trimester of pregnancy, during breastfeeding, and in infancy;
Salmeterol – for inhalation, preferable for heart pathologies;
Foradil (Formoterol) - both tablets and powder for inhalation.

Xanthine derivatives

These drugs for the relief of spastic attacks, which cause the obstructive form of the disease, are produced both in the form of tablets, capsules, and injection solutions. Popular methylxanthines are:

Theophylline;
Aminophylline;
Theobromine;
Eufillin;
extended-release tablets: Theotard, Teopek, Retafil.

What medications should I take to treat bronchitis?

Anti-inflammatory drugs

The main role in the treatment of bronchitis is played by anti-inflammatory drugs aimed at reducing pain, eliminating fever and relieving the resulting inflammatory process.

The most popular anti-inflammatory drugs in the treatment of bronchitis are:

Paracetamol, which is intended to relieve fever and painful syndromes. It can be used both in the form of tablets and suspension. The maximum dose of the drug per day should not exceed 4 grams, and a single dose should not exceed one gram. Taking paracetamol is not recommended during pregnancy, as it easily crosses the placental barrier.

Prednisolone is one of the most effective anti-inflammatory drugs that has the ability to slow down the development of inflammation. However, due to the high risk of complications and side effects, it should be taken only under the strict supervision of doctors. Prednisolone tablets are prescribed and monitored only by a doctor after conducting a series of tests. The daily dosage of prednisolone should not exceed 200 mg.

Sinupret is a herbal medicine that is available both in the form of tablets and drops. The anti-inflammatory effect is based on the biologically active components that are included in its composition. It also has a restorative effect on the mucous membranes of the respiratory tract and promotes the removal of viscous secretions from the body. Sinupret is most effective when combined with antibacterial tablets.

The dosage of Sinupret is prescribed individually, but it should not exceed 6 tablets or 150 drops per day.

Erespal are tablets that have anti-inflammatory and antibronchoconstrictor (bronchodilator) effects. It can be prescribed both in the presence of chronic respiratory failure and without it. Drinking Erespal is recommended to inhibit the growth of substances that affect the development of bronchospasm.

The daily dosage of Erespal should be no more than 240 milligrams.

Antibiotics

Bronchodilators: what are they and when to take them?

Among the most effective drugs are:

Eufillin, which is available in tablet form and provides relaxation of the bronchial muscles, and also acts as a stimulator of contractions of the diaphragm. Taking aminophylline is accompanied by improved activity of the intercostal and respiratory muscles, and improved ventilation of the alveoli. You need to drink aminophylline after meals, 150 milligrams 1-3 times a day.
Ventolin is more often used for chronic bronchitis. Due to the fact that the drug is released in the form of an aerosol inhaler, it quickly reaches the sites of the disease and relieves bronchospasm. This leads to a decrease in resistance in the lungs, which is accompanied by easier breathing. Ventolin also provokes mucus secretion. The effect after inhalation occurs after five minutes, and the most pronounced effect is observed after half an hour. The dosage of Ventolin should not exceed 200 mcg/day.

Salbutamol is an effective aerosol that can significantly relieve bronchospasm and also reduce lung resistance. While taking the drug, an increase in the vital capacity of the lungs is observed. Has a long lasting positive effect. The aerosol dosage is prescribed based on individual needs. Salbutamol is also available in tablet form and in this form can be prescribed to both adults and children.

Mucolytic drugs

An integral part of the treatment of bronchitis are mucolytic drugs. They help liquefy and remove mucus, which speeds up the healing process.

The following drugs are mainly prescribed:

Bromhexine, which is available in the form of solution, syrup and tablets. It has not only a mucolytic effect, but also an expectorant. Drinking Bromhexine is necessary to dilute bronchial secretions, which facilitates its rapid removal. The maximum dose of Bromhexine in tablet form should not exceed 64 mg/day, and in the form of inhalation - no more than 16 mg/day.
Ambrobene is one of the most effective mucolytic drugs, the main active drug of which is ambroxol. It has secretolytic, expectorant and secretomotor effects. The effect of taking Ambrobene occurs half an hour after administration, and its duration ranges from 6 to 12 hours. It is not recommended to drink Ambrobene together with antitussive medications, as this may cause sputum stagnation.

The greatest therapeutic effect of Ambrobene is manifested in the case of abundant fluid intake into the body, so its intake should be accompanied by plenty of drinking.

The dosage of the drug is prescribed based on personal characteristics, but it should not exceed 120 mg/day.

Lazolvan. It is based on ambroxol and has a pronounced mucolytic character. The drug perfectly stimulates mucus transport, which significantly improves sputum discharge and eases coughing attacks. It is not recommended to take Lazolvan together with antitussive tablets, as this will make it difficult to remove sputum. You can drink it 3 times a day, 1 tablet, or for a more pronounced effect - 2 times a day, 2 tablets.
ACC is an effective mucolytic drug that is effectively used even for chronic and purulent bronchitis. The composition of ACC helps reduce the viscosity of sputum, which facilitates its rapid removal. It is recommended to drink ACC after meals, and it is also advisable to drink plenty of fluids, which enhances the effect of the drug. The medicine should not be taken together with antitussive drugs. The dosage of ACC is prescribed individually and depending on the selected modification of this medicine.

Complementary therapy

To treat bronchitis with pronounced obstructions or its allergic form, antihistamines are used.

Any medications should be taken only as prescribed by the attending physician.

Obstructive bronchitis - what is it and how to treat it

Obstructive bronchitis is called inflammation of the bronchi with a sharp narrowing of the lumen, difficulty breathing, and respiratory failure. The disease is more common in children, is severe, and treatment takes longer than in adults.

Causes

With bronchitis, the irritating effect of viruses, bacteria, chlamydia, mycoplasmas causes a cough, leads to increased secretion of mucous secretions, the appearance of shortness of breath, and disruption of the functions of the respiratory system.

In children under 3 years of age, acute obstructive bronchitis is caused predominantly by respiratory syncytial (RS) viruses; the incidence of diseases among children is 45:1000.

The disease is characterized by narrowing of the bronchi, which impedes the movement of air.

Narrowing of the bronchi (obstruction) is caused by:

swelling of the respiratory tract mucosa;
spasm of bronchial smooth muscles.

In both adults and children, both mechanisms are involved in the development of bronchial obstruction, but they are expressed to varying degrees.

Edema causes the disease mainly in childhood, especially in children under 2 years of age. The diameter of the bronchi in children corresponds to their age, and the younger the child, the narrower the lumen of the airways.

Even slight swelling of the mucous membrane causes respiratory dysfunction in children. Bronchial obstruction, which prevents free exhalation, is a hallmark of obstructive bronchitis.

The cause of swelling may not only be an infection. An increased susceptibility to allergies can cause swelling of the bronchi.

In adults and adolescents, obstructive bronchitis is caused by bronchospasm, in which the lumen of the bronchi narrows so much that it significantly complicates exhalation and causes respiratory failure.

Risk factors

Ambient air pollution - exhaust gases, tobacco smoke, coal, flour dust, toxic chemical fumes;
viral diseases of the respiratory system;
hereditary factors.

Predisposing factors for the occurrence of bronchial obstruction are anatomical and hereditary features.

Children at risk include:

with insufficient birth weight;
suffering from enlarged thymus gland, rickets;
those who have had viral diseases for up to 1 year;
who were bottle-fed after birth;
with a predisposition to allergies.

Symptoms

The main symptoms of obstructive bronchitis are difficulty in exhaling, shortness of breath, and paroxysmal painful cough. The disease initially occurs in an acute form, acute obstructive bronchitis lasts from 1 week to 3 weeks.

If the acute form recurs more than 3 times during the year, the disease is diagnosed as recurrent bronchitis. If the recurrent form lasts more than 2 years, the chronic form of the disease is diagnosed.

Pronounced clinical symptoms of the disease may appear 3-5 days after the onset of inflammation. When signs of the disease appear, the child’s condition deteriorates sharply.

The breathing rate with difficult wheezing exhalation increases and can reach up to 50 breaths per minute. The temperature usually does not rise above 37.5 0 C.

Dry, clearly visible wheezing when exhaling is a characteristic sign of obstructive bronchitis.

To take a breath, you have to reflexively increase the activity of the auxiliary respiratory muscles. It is clearly noticeable how the wings of the baby’s nose swell and the muscles are drawn into the intercostal spaces.

Severe disease leads to respiratory failure and oxygen starvation of tissues. Symptoms manifest as a bluish discoloration of the skin of the fingertips and nasolabial triangle.

With obstructive bronchitis, shortness of breath appears in the morning and is intermittent. After coughing up sputum, shortness of breath decreases during daytime activities. Paroxysmal cough worsens at night.

Treatment

The main task in the treatment of obstructive bronchitis in adults is to eliminate the bronchospasm that caused respiratory failure.

Treatment of children

Treatment of obstructive bronchial disease in children is aimed primarily at eliminating bronchial edema and bronchospasm.

The choice of medications depends on the severity of these processes.

Even with moderate severity of the disease, children under one year of age must be hospitalized. It is very important to prevent progression of the disease in infants and children under 2 years of age. With obstructive bronchitis, it is dangerous to self-medicate.

Important! Antitussives are not prescribed for obstructive bronchitis; they can increase bronchospasm.

Medicines for children

All appointments can be made only by a pulmonologist based on X-rays of the lungs and blood tests.

In the treatment of obstructive bronchitis the following is used:

bronchodilators - drugs that relax the smooth muscles of the bronchial walls;
mucolytics that help thin sputum;
antibiotics;
anti-inflammatory drugs of hormonal and non-hormonal nature.

Prescribing antibiotics

Antibiotics for the treatment of obstructive bronchitis are prescribed to children when there is a threat of pneumonia or a bacterial infection.

The drugs of choice are macrolides, fluoroquinolones, cephalosporins, tetracyclines.

Indications for prescribing antibiotics in infants are:

a significant increase in temperature lasting more than 3 days;
severe phenomena of bronchial obstruction that cannot be treated with other means;
changes in the lungs indicating a risk of developing pneumonia.

The causative agents of infection in the first year of life are much more often than previously thought, chlamydial and mycoplasma infections (up to 20-40% of the number of children under one year old with bronchitis and pneumonia).

In addition, another common causative agent of bronchitis in children, the MS virus, causes changes in the bronchi, which weaken their own immunity and provoke the growth of their own microflora.

Thick mucus accumulated in the bronchi serves as an excellent breeding ground for colonies of various microorganisms - from bacteria to fungi.

For children of the first year of life, with an immature immune system, such a test can end tragically. Up to 1% of children under one year of age suffering from obstructive bronchitis, as well as bronchiolitis, die annually.

The drug of choice for the typical course of the disease with elevated temperature is amoxicillin + clavulanate.

If it is ineffective, an antibiotic from the macrolide group, cephalosporins, is prescribed.

Drugs that improve the condition of the bronchi

Drugs that relieve bronchospasm within 10 minutes are Salbutamol, Terbutaline, Fenoterol.

The spasm is not eliminated as quickly, but Clenbuterol, Atorvent, Traventol, and the combination drug Berodual act for a longer period of time.

These medications are taken by inhalation through a spacer - a mask that is placed on the face. In such a mask, the child can inhale the medicine without difficulty.

Inhalation treatment methods are widely used in the treatment of obstructive bronchitis. The use of aerosol inhalers and nebulizers can quickly improve the patient's condition.

Among the mucolytics, Bromhexine, ACC, Ambroxol are prescribed. Helps thin sputum and cleanse the bronchi by inhalation with Fluimucil-antibiotic, Fluimucil.

For this disease, treatment with oxygen inhalations and the use of medicinal plants are indicated.

The combination of thyme and plantain, the main components of Eucabal cough syrup, has a good effect on the condition of the bronchi.

In case of severe bronchial obstruction, which is difficult to treat, intravenous administration of hormonal drugs - Prednisolone, Dexamethasone - is prescribed.

Adults and children are prescribed Eufillin; in case of complicated disease, glucocorticoids (Pulmicort) and anti-inflammatory drugs (Erespal).

If you have an allergic predisposition, antihistamines may be required. Children up to one year old are prescribed Zyrtec, Parlazin, after 2 years they are treated with Claritin, Erius.

Inhalation through a nebulizer of soda and saline in combination with postural drainage, a technique that improves the discharge of sputum from the bronchi, has a positive effect on the health of children.

How is postural drainage performed?

The procedure is carried out after inhalation. Postural drainage lasts 15 minutes and consists of placing the patient in bed so that his legs lie slightly above his head. You can place a pillow under your feet or raise the edge of the bed.

During this procedure, the child must periodically change position, turn on his back, on his side, coughing up mucus. Drainage can be repeated after 3 hours. To obtain results, drainage must be carried out regularly.

If your child has a runny nose

With obstructive bronchitis, children often have a runny nose and chronic diseases of the ENT organs.

The flow of mucus, sputum with pus into the lower respiratory tract can cause a persistent cough.

The child must be seen by an ENT doctor and carefully monitor the condition of the baby’s nose. You can independently rinse your child’s nose with Dolphin and Aquamaris. Children over 5 years old are given instillation of mild vasoconstrictors, for example, Otrivin.

Complications

Acute obstructive bronchitis can cause:

bronchial asthma;
emphysema;
pneumonia.

Impaired respiratory function leads to oxygen deficiency in tissues and negatively affects the vital functions of absolutely all organs. In young children, the developing brain especially suffers from lack of oxygen.

Forecast

Acute obstructive bronchitis has a favorable prognosis if treated promptly.

The prognosis is more complex if the patient has an allergic predisposition and the disease becomes chronic.

Prevention

For frequent colds, you need to purchase an inhaler, and if symptoms of bronchial obstruction appear, inhalation with a pharmaceutical saline solution.

The peak incidence of bronchitis occurs in spring and autumn. At this time, you need to be especially careful about the child’s health, avoid hypothermia, and reduce the number of contacts with older children.

Patients with obstructive bronchitis should try to avoid places where smoking is allowed. It is necessary to maintain a sleep schedule, perform feasible physical exercises, and spend more time in the fresh air.

Prednisolone for asthma and bronchitis

Effect of the drug on allergies and inflammation

It has an effect in the following ways:

Prevents the destruction of lysosome membranes and the release of proteolytic enzymes. Thus, when tissue is damaged, pro-inflammatory proteolytic enzymes remain in lysosomes.
Reduces vascular permeability, prevents the outflow of blood plasma into tissues. The drug prevents the development of edema.
Inhibits the migration of leukocytes to the site of inflammation and phagocytosis of damaged cells.
It has an immunosuppressive effect, reducing the formation of lymphocytes and eosinophils. Large doses cause involution of lymphoid tissue.
Reduces fever by suppressing the release of interleukin-1 from leukocytes, which activates the hypothalamic thermoregulation center.
Suppresses the formation of antibodies.
Inhibits the reaction of interaction of foreign proteins with antibodies.
Inhibits the release of allergy mediators from basophils and mastocytes.
Reduces tissue sensitivity to histamine and other biologically active substances that have a pro-inflammatory effect.
Suppresses the biosynthesis of prostaglandins, interleukin-1, tumor necrosis factor.
Reduces the viscosity of mucus in the bronchi.
Increases the affinity of beta-adrenergic receptors of the bronchial tree for catecholamines, resulting in increased blood pressure.

Prednisolone suppresses allergic reactions and inflammation.

Under its influence, scarring of connective tissue slows down. Glucocorticoids stimulate the formation of red blood cells in the red bone marrow. Their long-term use can cause polycythemia.

Effect on metabolism

Long-term use of Prednisolone reduces the synthesis of corticotropin by the adenohypophysis, as a result of which the formation of endogenous glucocorticoids by the adrenal cortex decreases.

Forms of release of the drug

Produced in the form:

tablets of 1 and 5 mg,
injection solution containing 15 and 3 mg of active substance,
ointments for external use,
eye drops.

The drug has a systemic effect only when administered by injection or orally. Injections can be either intravenous or intramuscular.

Prednisolone for bronchial asthma

When choosing a basic therapy drug, the doctor must take into account the severity of asthma and the presence of complications. The age and body weight of the patient also matters. Prednisolone is prescribed for severe forms of the disease when inhaled corticosteroids do not have a therapeutic effect.

For other diseases of the respiratory system

Prednisolone is used not only to treat bronchial asthma, but also for the following diseases of the respiratory system:

acute alveolitis,
sarcoidosis,
tuberculosis,
aspiration pneumonia,
lung cancer,
purulent sore throat,
allergic bronchitis.

Prednisolone for bronchitis is used if the disease has an allergic etiology and is complicated by obstruction.

Contraindications

An absolute contraindication for taking the drug is individual intolerance to the active substance or auxiliary components. The medicine is used with caution when:

Side effects

The most common side effects during treatment:

obesity with the deposition of excess fat on the face and in the cervical-collar area,
increased blood glucose levels,
arterial hypertension,
arrhythmias,
bradycardia,
thrombosis,
disorders of the digestive system,
neuroses,
psychical deviations,
swelling,
delayed scar formation,
manifestations of allergies,
exacerbation of chronic infectious diseases.

Compared to other systemic hormonal drugs, Prednisolone has a weak mineralocorticoid effect and a mild effect on skeletal muscles.

What drugs can be replaced

For bronchial asthma, the following systemic glucocorticoids can be used:

methylprednisolone,
dexamethasone,
betamethasone,
triamcinolone.

Despite the similarity of effects on the body, the listed drugs cannot be considered complete analogues. They differ in metabolic rate, severity of therapeutic effect and side effects.

Triamcinolone is a drug with an intermediate duration of action. Causes side effects on the skin and muscles, and therefore its long-term use is undesirable.

Treatment of chronic obstructive bronchitis is usually outpatient (in the first week of bacterial exacerbation, it is recommended that the patient stay in a day hospital to select the optimal bronchodilator, bacteriological examination of sputum, and determine medical tactics). To begin treating obstructive bronchitis, it is extremely important to quit smoking and eliminate exposure to other factors that irritate the bronchi (for example, by changing work or place of residence).

Treatment of obstructive bronchitis with drugs

Based on the pathogenesis of obstructive bronchitis, the main groups of drugs for chronic obstructive bronchitis are bronchodilators and expectorants, glucocorticoids; when the process worsens, antibacterial drugs are prescribed for treatment.

Bronchodilators in the treatment of obstructive bronchitis

Bronchodilators in the treatment of obstructive bronchitis (bronchodilators)

Anticholinergics are first-line drugs in the treatment of chronic obstructive bronchitis. Ipratropium bromide is prescribed for treatment in the form of inhalation from a metering canister or as a solution through a nebulizer. Drugs for the treatment of obstructive bronchitis combine well with other bronchodilators and can be used for a long time. Ipratropium bromide is also produced in combination with beta2-adrenergic agonists (Berodual).

Selective beta2-adrenergic agonists (fenoterol, salbutamol, terbutaline) are used alone or as an addition to an anticholinergic blocker during an exacerbation of chronic obstructive bronchitis with increased obstructive syndrome for treatment. In older patients with obstructive bronchitis, the effectiveness of beta2-adrenergic agonists is reduced due to a decrease in the number of beta2-adrenergic receptors in the bronchi. In cases of severe bronchial obstruction, long-acting drugs are often used for treatment by inhalation (salmeterol, formoterol) or orally (saltos, volmax).

Xanthines should be used with caution for the treatment of obstructive bronchitis. Aminophylline IV drip at a rate of 0.5 mg/kg/h is indicated only during periods of severe exacerbation and when inhalation of other drugs is unavailable or ineffective. Aminophylline cannot be administered simultaneously, much less in the same solution with cardiac glycosides. Long-acting theophylline preparations (for example, Teopek, Theotard, Retafil) are prescribed as maintenance therapy in the treatment of obstructive bronchitis and insufficient effectiveness of inhaled ipratropium bromide.

A combination of drugs from different groups is prescribed for severe chronic obstructive bronchitis.

Glucocorticoids in the treatment of obstructive bronchitis

Glucocorticoids are used only in the treatment of severe broncho-obstructive syndrome (decrease in FEVx to 50% of the required values and below), not controlled by bronchodilators (long-acting drugs are not recommended for treatment). Drugs for obstructive bronchitis are usually prescribed in a dose of no more than 30 mg/day (in terms of prednisolone) orally for 7-14 days with a gradual dose reduction under the control of external respiration parameters. If there is insufficient effectiveness, drugs for inhalation use (for example, budesonide, fluticasone, flunisolide) are prescribed at a dose of 2 mg/day for up to 6 months for the treatment of obstructive bronchitis.

How to treat obstructive bronchitis with expectorants?

Expectorants for obstructive bronchitis (their combination with antitussives is strictly contraindicated). Acetylcysteine for the treatment of obstructive bronchitis (the effect develops on the 2-3rd day of treatment), bromhexine, ambroxol (the effect of both develops on the 4-7th day), expectorant mixture with potassium iodide. Inhalation of a 0.45-15% sodium chloride solution, steam inhalation with essential oils, and inhalation of a 2% sodium bicarbonate solution are also recommended.

Herbal medicine (for example, an infusion of thermopsis herb, a decoction of the root of the herb, an infusion of wild rosemary shoots, “Bronchicum” - in the form of tea, elixir, drops and baths) is used during the period of exacerbation, as well as during the period of remission for the treatment of obstructive bronchitis.

Treatment of obstructive bronchitis with antimicrobial therapy

The drugs of choice for obstructive bronchitis are aminopenicillins (for example, ampicillin, amoxicillin), macrolides, fluoroquinolones. Aminoglycosides can be prescribed only with verified gram-negative microflora. Bacteriological examination of sputum and determination of the sensitivity of the pathogen make it possible to more accurately select a drug for obstructive bronchitis.

Drugs of other groups for the treatment of obstructive bronchitis

For painful coughs, fenspiride (erespal) 80 mg 3 times a day for 4-8 weeks is recommended as an anti-inflammatory drug for treatment. In case of severe exacerbation of chronic obstructive bronchitis, heparin is used in the form of subcutaneous injections of 5000 units 4 times a day to improve microcirculation (which improves the rheological properties of sputum and has a beneficial effect on the inflammation process).

How to treat obstructive bronchitis?

Non-drug methods of treating obstructive bronchitis are aimed primarily at facilitating the expulsion of sputum (carried out against the background of treatment with expectorants and copious amounts of alkaline drinking). Positional drainage for obstructive bronchitis - periodic coughing using deep forced exhalation in a position optimal for sputum discharge. Coughing in combination with vibration massage: the patient lies down on a hard surface, loudly sings vowel sounds, and at this time the patient’s relatives or medical personnel often tap the ribs of their palms on his back. This procedure should be performed at least 2 times a day to treat obstructive bronchitis. Manual therapy for obstructive bronchitis (for example, post-isometric relaxation of the respiratory muscles and mobilization and manipulation effects on the sternocostal joints and motor segments of the thoracic and cervical spine).

Obstructive bronchitis - is treatment with folk remedies effective?

With obstructive bronchitis, the sputum becomes thick and viscous. It clogs the bronchi and prevents them from functioning normally, which not only causes a painful cough, but can also lead to respiratory and heart failure. However, it should be understood that although traditional medicine recipes have a mild effect and have no side effects, in the case of obstructive bronchitis, folk remedies for treatment can only be used together with drug therapy, which means you should consult a doctor before using them.

Treatment of obstructive bronchitis with herbal medicine

Herbal medicine is indicated both during exacerbations of chronic obstructive bronchitis and as a maintenance treatment. Herbal medicines are prescribed in the form of infusions, teas, elixirs, drops, lozenges, balms and even baths. Ipecac root (infusion 0.6:200), thermopsis herb (infusion 1:200), lycorine hydrochloride, istod root (decoction 20:200) are expectorants of reflex action. Official herbal medicines for the treatment of obstructive bronchitis include "Bronchicum" based on thyme, grindelia herb, primrose root, quebracho bark, pine and eucalyptus oils, camphor and other herbal components (for chronic obstructive bronchitis, drops, elixir, tea and baths of "Bronchicum" are used ). An infusion of wild rosemary shoots is often quite effective for the treatment of bronchitis (1 teaspoon per glass of boiling water, a glass of infusion is drunk gradually throughout the day, every day for a month). There are many recipes that are prepared at the rate of 1 tablespoon per 200 ml of water for the treatment of obstructive bronchitis; The mixture is boiled for 15 minutes and left for several hours, then filtered and stored in a dark container in the refrigerator. Here are the two most commonly used recipes: marshmallow root (2 parts), coltsfoot leaves (2 parts), oregano herb (1 part); marshmallow root and licorice root (2 parts each), dill fruits (1 part).

Hospitalization for obstructive bronchitis

Treatment of obstructive bronchitis - indications for hospitalization

An exacerbation of obstructive bronchitis, characterized by increased shortness of breath, cough or sputum production, or any of the following symptoms.
Ineffectiveness of treatment of obstructive bronchitis in outpatient settings.
Increasing symptoms of obstructive bronchitis, the inability of the patient to move around the room (for a previously mobile person).
Inability to eat or sleep due to shortness of breath.
Threatening hypoxemia.
The appearance or increase of hypercapnia.
The decision of the family and/or physician that the patient cannot be treated for obstructive bronchitis at home due to the lack of emergency care.
High probability of concomitant pulmonary and extrapulmonary diseases.
Mental disorders.
The emergence or progression of cor pulmonale despite outpatient treatment of obstructive bronchitis.
The combination of chronic obstructive bronchitis with other diseases accompanied by deterioration of pulmonary ventilation, during a planned invasive surgical or diagnostic procedure with the use of drugs that depress the respiratory center, for example, narcotic analgesics.

Inpatient rehabilitation for the treatment of obstructive bronchitis

Indications for hospitalization in the intensive care unit for obstructive bronchitis (if one of the following signs is present): severe shortness of breath that cannot be relieved in the general ward of the therapeutic department, confusion, paradoxical contractions of the diaphragm, increasing hypoxemia and hypercapnia, the need for mechanical ventilation. Criteria for discharge from the hospital during the treatment of obstructive bronchitis: absence of shortness of breath at rest and during moderate physical activity (the patient can move freely and care for himself), monitoring the state of bronchial patency during outpatient treatment, stable blood gas composition.

Educational programs in the treatment of obstructive bronchitis

Educational programs for patients with obstructive bronchitis serve as a guarantee of their cooperation with the doctor in the treatment of chronic obstructive bronchitis, which lasts for many years. Despite the fact that the disease is not completely curable, the patient should be convinced of the possibility of improving his condition and the need to prevent the progression of the disease. He needs to be explained that sputum should not be allowed to stagnate in the bronchi during obstructive bronchitis; the cough should not be “superior,” unproductive, or “barking.” It is necessary to periodically cough using deep forced exhalation, expelling sputum from the distal parts of the lungs, while finding the body position that is optimal for the discharge of sputum (positional drainage). It is necessary that his relatives of people with obstructive bronchitis at home or medical personnel in a hospital at least 2 times a day help him cough through vibration massage. These activities are carried out against the background of taking expectorants and drinking plenty of alkaline drinks.

Complications after treatment of bronchitis

As chronic obstructive bronchitis progresses, chronic respiratory and then pulmonary heart failure (chronic cor pulmonale) develops. Initially, an obstructive type of external respiration disorders is formed; As pulmonary emphysema and fibrotic changes form and progress, the disorders become mixed due to a decrease in vital capacity. Hypoxemia, reflex pulmonary vasoconstriction with subsequent pulmonary hypertension, increased intrathoracic pressure lead to overload of the right heart and the formation of cor pulmonale. Treatment of pulmonary heart failure in chronic obstructive bronchitis coincides with the treatment of the underlying disease, in particular with bronchodilator therapy. The use of cardiac glycosides for pulmonary heart failure is indicated only in the formation of left ventricular failure. The prescription of this group of drugs for cor pulmonale in more than 40% of cases is accompanied by the occurrence of arrhythmias (more often than with other types of heart failure). When prescribing diuretics for the treatment of obstructive bronchitis, this group of patients requires constant monitoring of potassium levels in the blood serum. Low-flow long-term (up to 16 hours per day) oxygen therapy using oxygen concentrators is recognized as a rational method of maintenance therapy for severe pulmonary heart failure.

Prognosis for treatment of obstructive bronchitis

Without stopping smoking, eliminating other irritants, and treating infectious exacerbations, chronic obstructive bronchitis steadily progresses. The prognosis also depends on the age of the patient, the degree of decrease in FEVx at the time of diagnosis of the disease and its increase after the use of bronchodilators, and the type of process (bronchitis or emphysematous). Frequent bacterial exacerbations worsen the prognosis of treatment of obstructive bronchitis.

Prevention of obstructive bronchitis

Prevention of the progression of chronic obstructive bronchitis consists primarily of improving the condition of inhaled air and combating smoking, which in many countries has become national programs. In addition, chronic exposure to other bronchial irritants should be avoided. For patients with frequent infectious exacerbations of chronic obstructive bronchitis, vaccination during remission, prescription of drugs to strengthen the immune system (herbal medicines, nutritional supplements, multivitamins), and hardening are indicated.

Clinical examination in the treatment of chronic obstructive bronchitis

Constant monitoring by a therapist at the place of residence is required (visits at least once every 6 months with monitoring of respiratory function) in the treatment of obstructive bronchitis.

Labor examination and employment for obstructive bronchitis

In the early stages of chronic obstructive bronchitis, there is no need for medical and social examination, since rational therapy can stop the progression of the disease and the development of respiratory failure, which is the main cause of decreased ability to work. A change of place of work is relevant only in the presence of occupational hazards associated with inhalation of irritating substances, fumes and dust, and sudden temperature changes. In the presence of respiratory failure, confirmed by a decrease in OOBi and PEF below 70% of the required values, specialties associated with physical activity are added to the list of professions that patients should avoid. Currently, the problem of conducting a medical and social examination for chronic obstructive bronchitis is the lack of a unified system for assessing the patient’s condition in the institutions of the Ministry of Health and institutions of the Ministry of Social Security.

With bronchitis, the irritating effect of viruses, bacteria, chlamydia, mycoplasmas causes a cough, leads to increased secretion of mucous secretions, the appearance, and disruption of the functions of the respiratory system.

In children under 3 years of age, acute obstructive bronchitis is caused predominantly by respiratory syncytial (RS) viruses; the incidence of diseases among children is 45:1000.

The disease is characterized by narrowing of the bronchi, which impedes the movement of air.

Narrowing of the bronchi (obstruction) is caused by:

swelling of the respiratory tract mucosa;
spasm of bronchial smooth muscles.

In both adults and children, both mechanisms are involved in the development of bronchial obstruction, but they are expressed to varying degrees.

Even slight swelling of the mucous membrane causes respiratory dysfunction in children. Bronchial obstruction, which prevents free exhalation, is a hallmark of obstructive bronchitis.

The cause of swelling may not only be an infection. An increased susceptibility to allergies can cause swelling of the bronchi.

Risk factors

Ambient air pollution - exhaust gases, tobacco smoke, coal, flour dust, toxic chemical fumes;
viral diseases of the respiratory system;
hereditary factors.

Predisposing factors for the occurrence of bronchial obstruction are anatomical and hereditary features.

Children at risk include:

with insufficient birth weight;
suffering from enlarged thymus gland, rickets;
those who have had viral diseases for up to 1 year;
who were bottle-fed after birth;
with a predisposition to allergies.

Symptoms

If the acute form recurs more than 3 times during the year, the disease is diagnosed as recurrent bronchitis. If the recurrent form lasts more than 2 years, it is diagnosed.

Pronounced clinical symptoms of the disease may appear 3-5 days after the onset of inflammation. When signs of the disease appear, the child’s condition deteriorates sharply.

The breathing rate with difficult wheezing exhalation increases and can reach up to 50 breaths per minute. The temperature usually does not rise above 37.5 0 C.

Dry, clearly visible wheezing when exhaling is a characteristic sign of obstructive bronchitis.

Severe disease leads to respiratory failure and oxygen starvation of tissues. Symptoms manifest as a bluish discoloration of the skin of the fingertips and nasolabial triangle.

With obstructive bronchitis, shortness of breath appears in the morning and is intermittent. After coughing up sputum, shortness of breath decreases during daytime activities. Paroxysmal.

Treatment

The main task in the treatment of obstructive bronchitis in adults is to eliminate the bronchospasm that caused respiratory failure.

Treatment of children

Treatment of obstructive bronchial disease in children is aimed primarily at eliminating bronchial edema and bronchospasm.

The choice of medications depends on the severity of these processes.

Important! Antitussives are not prescribed for obstructive bronchitis; they can increase bronchospasm.

Medicines for children

All appointments can be made only by a pulmonologist based on X-rays of the lungs and blood tests.

In the treatment of obstructive bronchitis the following is used:

– agents that relax the smooth muscles of the bronchial walls;
mucolytics that help thin sputum;
anti-inflammatory drugs of hormonal and non-hormonal nature.

Prescribing antibiotics

Antibiotics for the treatment of obstructive bronchitis are prescribed to children when there is a threat of pneumonia or a bacterial infection.

The drugs of choice are macrolides, fluoroquinolones, cephalosporins, tetracyclines.

Indications for prescribing antibiotics in infants are:

a significant increase in temperature lasting more than 3 days;
severe phenomena of bronchial obstruction that cannot be treated with other means;
changes in the lungs indicating a risk of developing pneumonia.

In addition, another common causative agent of bronchitis in children, the MS virus, causes changes in the bronchi, which weaken their own immunity and provoke the growth of their own microflora.

Thick mucus accumulated in the bronchi serves as an excellent breeding ground for colonies of various microorganisms - from bacteria to fungi.

The drug of choice for the typical course of the disease with elevated temperature is amoxicillin + clavulanate.

If it is ineffective, an antibiotic from the macrolide group, cephalosporins, is prescribed.

Drugs that improve the condition of the bronchi

Drugs that relieve bronchospasm within 10 minutes are Salbutamol, Terbutaline, Fenoterol.

The spasm is not eliminated as quickly, but Clenbuterol, Atorvent, Traventol, and a combination drug last longer.

These medications are taken by inhalation through a spacer - a mask that is placed on the face. In such a mask, the child can inhale the medicine without difficulty.

Inhalation treatment methods are widely used in the treatment of obstructive bronchitis. The use of aerosol inhalers allows you to quickly improve the patient's condition.

Among the mucolytics, Bromhexine, ACC, Ambroxol are prescribed. Helps thin sputum and cleanse the bronchi by inhalation with Fluimucil.

For this disease, treatment with oxygen inhalations and the use of medicinal plants are indicated.

The combination of thyme and plantain, the main components of Eucabal cough syrup, has a good effect on the condition of the bronchi.

In case of severe bronchial obstruction, which is difficult to treat, intravenous administration of hormonal drugs - Prednisolone, Dexamethasone - is prescribed.

Adults and children are prescribed Eufillin; in case of complicated disease, glucocorticoids (), anti-inflammatory drugs ().

If you have an allergic predisposition, antihistamines may be required. Children up to one year old are prescribed Zyrtec, Parlazin, after 2 years they are treated with Claritin, Erius.

Saline solution in combination with postural drainage - a technique that improves the discharge of sputum from the bronchi - has a positive effect on the health of children.

How is postural drainage performed?

If your child has a runny nose

With obstructive bronchitis in children, chronic symptoms are often observed.

The flow of mucus, sputum with pus into the lower respiratory tract can cause a persistent cough.

The child must be shown and the condition of the baby’s nose must be carefully monitored. You can independently rinse your child’s nose with Dolphin and Aquamaris. Children over 5 years old are given soft instillations, for example, Otrivin.

Complications

Acute obstructive bronchitis can cause:

bronchial asthma;
emphysema;
pneumonia.

Forecast

Acute obstructive bronchitis has a favorable prognosis if treated promptly.

The prognosis is more complex if the patient has an allergic predisposition and the disease becomes chronic.

Prevention

For frequent colds, you need to purchase an inhaler, and if symptoms of bronchial obstruction appear, inhalation with a pharmaceutical saline solution.