Treatment of bronchial asthma is recommended to be carried out step by step, controlling the patient's clinical response to treatment and parameters of lung function. The patient needs to be taught how to use the inhaler correctly.
The drug SEROFLO is not used for the treatment of asthmatic status or other acute attacks of bronchospasm, since in such cases, a rapid and short-acting inhaled bronchodilator should be used (for example, salbutamol). Patients should be informed that they always have on hand a drug to stop acute symptoms.
The combination of salmeterol and fluticasone propionate can be used for initial maintenance therapy in patients with persistent asthma (daily occurrence of symptoms or daily use of an agent for arresting seizures), if there is evidence of SCS administration and when determining their approximate dosage.
More frequent use of short-acting bronchodilators for relief bronchospasm indicates a worsening of the course of the disease. In this case, the patient should consult a doctor.
The sudden and increasing current of the bronchospasm syndrome poses a potential threat to life. Patients in this condition should be under the supervision of a physician.
If the used dose of the drug SROROFLO does not provide adequate control of the disease, then the patient should also consult a doctor who may reconsider the treatment regimen.
Because of the risk of developing an exacerbation of the disease, treatment with SROOFLO can not be abruptly stopped, the dose of the drug should be reduced gradually under the supervision of the doctor.
In patients with COPD, the withdrawal of the drug may be accompanied by symptoms of decompensation and requires the supervision of a physician. Doctors should be aware of the possibility of developing pneumonia in patients with COPD receiving the drug, as the clinical picture of pneumonia and exacerbations of COPD are often similar.
Any inhaled glucocorticosteroids can cause systemic effects, especially with prolonged use in high doses, however, the likelihood of such symptoms is much lower than when treated with oral GCS. Possible systemic effects include Cushing's syndrome, cushingoid features, suppression of adrenal function, growth retardation in children and adolescents, reduction of bone mineral density, cataract and glaucoma.Given this, the dose of inhaled glucocorticosteroids should be reduced to the lowest dose, which can ensure the maintenance of effective treatment.
It is recommended to regularly measure the growth of children who receive long-term inhaled glucocorticosteroids.
In emergency situations that can cause stress, it is necessary to remember the possible suppression of adrenal function and the emergence of the need for systemic GCS.
When carrying out resuscitation measures or surgical interventions in patients with bronchial asthma and severe COPD, it is necessary to monitor the indices of adrenal function.
Due to the possibility of suppression of the function of the adrenal glands, patients transferred from the GCS for oral administration (systemic action) to inhalation therapy with fluticasone propionate (topical action) should be treated with extreme caution and regularly monitored their function as the adrenal cortex. When transferring patients from taking systemic GCS to inhalation therapy, allergic reactions (for example, allergic rhinitis, eczema), which were suppressed by systemic GCS, may appear.In such situations it is recommended to carry out symptomatic treatment with antihistamines and / or topical preparations, incl. GCS for topical application. After initiation of treatment with inhaled fluticasone propionate, systemic GCS should be discontinued gradually, and such patients should carry a special card containing an indication of the possible need for additional administration of SCS in stressful situations.
When taking salmeterol, the risk of serious unwanted reactions in the treatment of bronchial asthma from the respiratory system or death in patients of African American origin is presumably higher than in other patients. The importance of pharmacogenetic factors or other causes is unknown. The effect of concomitant use of inhaled glucocorticosteroids on the risk of lethal outcomes in patients with bronchial asthma has not been studied.
The drug SEROFLO, like other inhaled medications, can cause a paradoxical bronchospasm. In this case, a short-acting inhaled bronchodilator should be immediately applied, the preparation SEROFLO should be withdrawn and an alternative therapy should be started if there is evidence.
There are reports of adverse events associated with the pharmacological action of beta2-agonists, such as tremor, subjective palpitation and headache. However, these phenomena are of a short-term nature, and their severity decreases with regular therapy.
In patients with exacerbation of bronchial asthma, hypoxia, it is necessary to monitor the concentration of potassium in the blood plasma.
There are very few reports of an increase in blood glucose, and this should be taken into account when appointing a combination of salmeterol and fluticasone propionate in patients with diabetes mellitus.
To reduce the manifestations of such side effects of fluconazole propionate, like candidiasis of the oral and pharyngeal mucosa, hoarseness, it is necessary to rinse the mouth and throat with water after inhalation of the drug SEROFLO.