How to quickly remove berodual from the body. Berodual overdose

An overdose of Berodual leads to severe complications, if emergency medical care is not provided, it becomes the cause fatal outcome. Children and elderly people with weakened immune defenses are especially susceptible to poisoning.

ICD 10 code T36-T50.

Characteristics of the drug

The medicine is intended for inhalation. The positive effect is achieved thanks to the active components:

Ipratropium bromide. Belongs to the group of m-anticholinergics, eliminates bronchospasms caused by the vagus nerve, and reduces the production of secretions.
Fenoterol bromide. Beta2-adreomimetic dilates the bronchi, preventing the contraction of muscle tissue.

The complex use of these substances ensures:

Stimulation respiratory system.
Relaxation of blood vessels.
Preventing the secretion and accumulation of sputum.
Elimination of spasm.

Berodual is available in 2 forms:

A ready-made solution that is convenient to use if you have an inhaler.
Metered aerosol.

The action begins a few minutes after administration and lasts 6 hours.

You should not shorten the intervals between sessions, as the risks of overdose are high.

Indications

Berodual is prescribed for the following pathologies:

Pneumonia.
Laryngitis.
Tracheitis.
Bronchial asthma.
Emphysema.
Obstructive syndrome in tuberculosis.
An allergic reaction that results in severe coughing.

The drug can also be used for preventive purposes.

Contraindications

It is prohibited to use Berodual in the following conditions:

Hypersensitivity to ingredients.
Tachycardia.
Previous myocardial infarction.
Failure coronary vessels, ischemia.
Hypertension.
Angle-closure glaucoma.
Prostate hypertrophy.
Bladder infections.
Diabetes.
First trimester of pregnancy.
Breast-feeding.

Berodual is contraindicated for treating a child under 6 years of age. Prescribe with caution for chronic liver and kidney diseases.

During the therapeutic course, side effects may develop:

cephalgia;
dizziness;
nervousness;
increased heart rate;
changes in pressure indicators;
nausea and vomiting;
rash like urticaria;
swelling of the tongue, lips, face.

If such signs appear, stop treatment and consult a doctor who will replace the drug.

Causes of poisoning

Intoxication occurs as a result of:

Non-compliance with inhalation regimen, overdose.
Exceeding the recommended dose of Berodual in an effort to achieve the effect faster.
Accidental use by a child due to the carelessness of parents.

Damage is also likely due to insufficient cleaning of the nebulizer, which leads to accumulation of medication. It is necessary to thoroughly wash the inhaler after each session.

Clinical picture of overdose

Berodual poisoning is accompanied by characteristic symptoms, which occur more clearly in children:

Aching pain in the chest.
A jump in blood pressure.
Tachycardia and arrhythmia.
Tremor of the limbs.
Increased bronchial spasm.
Redness of the skin.
Unquenchable thirst.
Coughing.
Mental abnormalities.
The pupils dilate and vision becomes blurred. Characteristic signs– blurry image, splitting.
Possible bleeding in the eyes.
Nausea, excessive vomiting.
An allergic reaction can lead to angioedema.

In case of severe overdose, the blood pressure gradually decreases, which provokes a coma. Failure to provide assistance leads to death.

Lethal dose

The instructions clearly state the norms for using Berodual in the form of an aerosol:

To relieve acute bronchospasm, 2 servings are enough.
If there is no effect, inhalation can be repeated after 5 minutes.
The maximum permissible quantity is 4.
More than 8 is the cause of overdose and sometimes death.

If a ready-made solution is used:

A child under 6 years of age is susceptible to intoxication when the volume of 2 ml is exceeded during the day.
Single use of more than 4 ml is dangerous.

The condition may worsen misuse. For example, diluting Berodual for inhalation is allowed only with saline solution.

First aid

The active components enter the body through the respiratory system. Therefore, in case of overdose, usual measures, such as gastric lavage and the use of sorbents, are useless.

Certainly, Small child may take the medicine accidentally. But it is undesirable to provoke artificial vomiting, since there is a high probability of damage to the gastrointestinal mucosa. It is necessary to urgently call an ambulance team.

Antidote

The antidote is cardioselective β-blockers - Betaxol, Atenolol, Sectral. But they are used with caution, as there are risks of blocking the bronchial lumens.

Diagnostics

If a person is admitted to the hospital with signs of an overdose, an examination is performed simultaneously with treatment. An ECG is performed and blood and urine samples are taken for study in the laboratory. Depending on the results, the therapy program is adjusted.

Treatment methods

The main procedures are aimed at restoring the respiratory system and the functioning of the heart muscle:

Oxygen inhalation and artificial ventilation are indicated.
Antispasmodics are used to eliminate bronchospasm.
At allergic reaction Antihistamines are prescribed.
Possible use of corticosteroids hormonal drugs– Dexamethasone or Prednisolone.
At high blood pressure Papaverine hydrochloride is administered subcutaneously, Aminazine intramuscularly or Eufillin intramuscularly.
In case of psychomotor agitation, tranquilizers are recommended - Relanium.
If there are risks of angle-closure glaucoma, use Diacarb orally and Pilocarpine topically.

In case of cardiac arrest and lack of breathing, resuscitation procedures are resorted to.

Possible consequences

If first aid is provided immediately after an overdose of Berodual, characteristic symptoms eliminated within 1–3 days. With significant intoxication, complications are likely to develop:

pneumonia;
stroke;
myocardial infarction.

Elderly patients are especially susceptible to such risks.

Prevention

It is easy to avoid an overdose by following some rules:

Berodual should be stored in a place protected from light, at temperatures up to 25 °C.
After each session, rinse the inhaler thoroughly.
If there is no positive effect, do not increase the volume of the product.
Don't keep it in sight.

The drug quickly relieves the symptoms of the disease, but uncontrolled use often provokes poisoning. Therefore, pathologies should be treated with Berodual as prescribed by a doctor.

Difficulty breathing due to bronchial asthma and chronic forms obstructive bronchitis is caused by bronchospasm. To eliminate it, medications with a bronchodilator (dilating the bronchi) effect are used, one of such drugs is Berodual inhalation aerosol. It consists of two active components: iprotropium bromide (m-anticholinergic) and fenoterol bromide (beta 2-adrenergic agonist). They complement each other, providing high-quality relaxation of the muscular lining of the bronchi and rapid relief of bronchospasm.

Violating the rules for taking the drug, increasing the prescribed dose or frequency of administration can cause an overdose.

Source: ic1.static.km.ru

The aerosol is intended for the treatment of adults and children over 6 years of age. To relieve bronchospasm, 2 inhalation doses are usually recommended. If the attack does not resolve within 5 minutes, repeated use of the drug in the same dose is allowed. Thus, the maximum permissible single dose of Berodual is 4 inhalation doses.

The drug can be used not only for a single dose, but also for long-term therapy. In this case, 1-2 inhalation doses are usually prescribed 3-4 times a day. Taking more than 8 doses of Berodual during the day leads to an overdose.

Signs of overdose

The main symptoms of an overdose of Berodual:

pain in the heart area;
increased blood pressure;
arrhythmia;
tachycardia;
increased pulse pressure;
paradoxical bronchospasm;
tremor;
facial redness;
increased thirst;
cough;
nausea, vomiting;
allergic reactions (urticaria, Quincke's edema);
mental disorders.

In case of severe overdose arterial hypertension and tachycardia are quickly replaced by hypotension and bradycardia, and collapse develops.

An overdose of Berodual can lead to acute attack angle-closure glaucoma. Its signs:

headache localized on the affected side, radiating to the temple;
pain in the orbit of the affected eye, redness, swelling;
the pupil is irregularly shaped and dilated;
sometimes – hemorrhages in the cornea;
rapidly increasing disturbances visual function (visible objects are perceived blurry, colored spots and glare appear before the eyes);
sometimes - nausea, vomiting.

Source: depositphotos.com

First aid for overdose

First aid if symptoms of an overdose of Berodual appear is to stop using it, after which you should call ambulance or take the victim to the hospital yourself.

Antidote

A specific antidote to Berodual is cardioselective beta-blockers (Atenolol, Sectral, Betaxol).

When is medical help needed?

In case of an overdose of Berodual, medical assistance is necessary in 100% of cases.

Cardioselective beta-blockers (antidote to Berodual) are prescribed with sufficient caution, with careful selection of the dose, since errors in their use can increase the severity of bronchial obstruction.

In addition to the specific, it is carried out symptomatic treatment aimed at eliminating respiratory and of cardio-vascular system or to prevent their development:

for breathing disorders - inhalation of humidified oxygen. Rise respiratory failure is the basis for transferring the patient to artificial ventilation. In order to relieve paradoxical bronchospasm, antispasmodic and anticholinergic drugs are prescribed; according to indications, corticosteroid hormones (Prednisolone, Dexamethasone) and/or antihistamines(Tavegil, Pipolfen, Suprastin);
to lower blood pressure - injections of a 2% solution of Papaverine hydrochloride (subcutaneous), 2.5% solution of Aminazine (intramuscular) or 2.4% solution of aminophylline (intravenously);
to relieve psychomotor agitation - tranquilizers (Seduxen, Relanium);
if an attack of angle-closure glaucoma develops, use the standard algorithm for its relief (Diacarb intravenously or orally, 2% solution of Pilocarpine topically, etc.);
in case of respiratory and cardiac arrest - a full range of resuscitation measures.

Possible consequences

In the case of a mild overdose of Berodual and timely assistance, the symptoms of an overdose usually disappear within 24 hours and, as a rule, have no consequences.

In case of severe intoxication, the prognosis is less favorable, since complications are common:

pneumonia due to respiratory distress;
spicy vascular disorders(stroke, myocardial infarction) against the background sharp increase blood pressure, especially in older people.

Video from YouTube on the topic of the article:

Almost any medicinal product is dangerous if used in unreasonable dosages. In case of shortage exact dosage may not develop necessary pharmacological effect, and in case of overdose, on the contrary, when the indicated doses are exceeded, the instructions contain not only the required pharmachologic effect, but side effects often occur. overdose carries with it increased danger, as without using higher doses, this drug often has side effects.

Berodual

Berodual is an anti-asthmatic drug based on the beta-adrenergic receptor stimulant fenoterol hydrobromide. The second component, ipratropium bromide, is an ammonium derivative that has anticholinergic properties. In general, the medicine quickly stops a painful attack and helps completely prevent exacerbation bronchial asthma. Berodual is also prescribed for pulmonary emphysema, chronic bronchitis, bronchospastic syndrome, and preventive rehabilitation of nosological units. Release form: aerosol for inhalation and solution for inhalation.

What can happen with an overdose of Berodual

So, here are the main symptoms of an overdose:

Pain and spasms in the area of the heart muscle
Increased blood pressure
Mental problems, increased nervous agitation
Acceleration and irregular heart rhythm
Allergic reactions, including swelling of the larynx or bronchospasm
Heart rate acceleration
Vomiting and nausea
Paradoxical bronchospasm
Hand trembling
Cough
The desire to drink is almost constant.

Long-term and acute overdoses may cause pneumonia or stroke. The maximum permissible one-time number of doses is 4, and no more than 8 can be administered per day, because anything higher leads to an overdose.

If such signs appear, you should first stop taking the medicine or at least sharply reduce the dosage. The only antidotes can be considered drugs from the group of beta blockers, and it is advisable to choose cardioselective ones, because berodual affects the health of the heart muscle. These include: atenolol, betaxol and sectral. The dosage of beta blockers should be selected carefully so as not to provoke increased bronchial obstruction while taking the drug.

Bronchial asthma is chronic illness which cannot be completely cured. It is manifested by attacks of difficult exhalation, which occurs due to spasm of the bronchial muscles. Also, a similar clinical picture may have Chronical bronchitis with obstruction. During an asthma attack, a person begins to choke.

To help restore patency respiratory tract, use bronchodilator drugs. They relax muscles and relieve spasms. Such a drug is Berodual. Bronchodilator medications require precise dosage. If you violate the dosage regimen or increase the dose or number of Berodual uses without permission, symptoms of overdose will appear.

How to take Berodual

Berodual consists of two main active ingredients - iprotropium and fenoterol bromide. Thanks to their combined effect on the patient’s body, rapid relaxation of the bronchial muscles and relief of spasm are ensured.

The use of the aerosol is permitted only for adults and children over the age of 6 years. To stop an attack of bronchial asthma, 2 doses are usually sufficient. If bronchospasm does not go away after 5-7 minutes, re-use of the drug is allowed.

One-time maximum dose the drug should not exceed four inhalations. It is also not recommended to use more than 8 inhalations within 24 hours, as Berodual poisoning may occur.

In addition to single-stage administration, the drug is used for long-term therapy. Berodual is not particularly addictive, but over time the body’s resistance may develop. Then a larger dose is used to relieve the attack, since the bronchi will stop responding.

Signs of Berodual poisoning

If into the body a person will be hit too much active substance, poisoning may develop. Most often this happens due to the patients’ negligence towards their health and the dose being incorrectly selected by the specialist.

The first signs of an overdose may appear almost immediately after admission large dose into the body. The patient's face will turn red, and he will begin to cough violently, sometimes to the point of vomiting. Tremors (shaking) of the limbs or the whole body may appear.

The patient will complain about painful sensations behind the sternum, in the region of the heart, severe nausea and at the same time thirsty. Rising quickly arterial pressure and heart rate, tachycardia and arrhythmia (irregular rhythm and rapid heartbeat) occur. In some situations, paradoxical bronchospasm may develop, which is very difficult to relieve.

In cases of severe poisoning, hypertension and tachycardia almost immediately change to bradycardia and hypotension. That is, blood pressure and heart rate first jump sharply to high values, and then they fall just as sharply. Collapse occurs.

Sometimes an overdose of Berodual occurs in the form of closed-angle glaucoma. Then the symptoms are somewhat different. The patient complains of severe headache, which is localized in the side in which the eye damage occurred. Quite often it can radiate to the temple (see).

Upon examination eyeball reddened, tearing is noted, hemorrhage in the sclera or cornea may be visible. The pupil acquires irregular shape, often expanded. The patient says that he sees multi-colored spots before his eyes, and all objects look blurry. In rare cases, vomiting and nausea may occur (see).

How to give first aid

All that can be done in case of an overdose of Berodual is to stop the effect of the drug on the victim’s body and call an ambulance. And poisoning therapy will be carried out by specialists. Even if the overdose of Berodual was insignificant, you should not neglect medical care, since the consequences may appear much later than the poisoning itself.

Initially, specific therapy is used. For this purpose, beta-blockers (Betaxol, Sectral) are used. They are a kind of antidotes to bronchodilator drugs. But it should be remembered that they should be prescribed with great caution, since the slightest flaws in the dosage can provoke new attacks of bronchial asthma and aggravate the patient’s condition.

Secondly, treatment and prevention of disorders from various organs is carried out:

To avoid the development of respiratory failure, use oxygen inhalations (see), which is moistened using a special apparatus. IN difficult situations can be added to oxygen hormonal drugs. If the insufficiency progresses and the patient cannot breathe normally on his own, then he is connected to the device artificial ventilation lungs.
Sometimes poisoning can cause disturbances in mental health person. To level out psychomotor agitation, the patient is administered tranquilizers - Relanium, Seduxen.
If the patient has severe arterial hypertension, and the pressure does not return to normal, then a set of injections is prescribed - Papaverine, Aminazine and Eufillin.
In case of development of angle-closure glaucoma, standard measures are taken to stop it - intravenous administration Diacarba and local application Pilocarpine.

What are the dangers of overdose?

If the intoxication was not severe, and the patient turned to the medical institution, where he received competent assistance (see), then severe consequences practically does not occur. Clinical picture overdose gradually fades away and disappears completely after 24 hours.

When the dose taken significantly exceeds the permitted dose, and symptoms of poisoning appear in severe forms, the risk of complications increases significantly. Most often, due to impaired ventilation, such patients develop pneumonia. Sometimes the course of the underlying disease, bronchial asthma, worsens.

Strong in the background high blood pressure and then him sharp jump down, disorders often occur in the cardiovascular system:

myocardial infarction;
ischemic stroke;
hemorrhagic stroke;
thrombosis.

Especially dangerous overdose Berodual is for children and the elderly. An overdose of Berodual manifests itself with severe symptoms. If you don’t know what to do and don’t provide help to the patient, then even death can occur. Therefore, it is important to follow the rules of admission this drug, and in case of poisoning, consult a doctor immediately.

Berodual is a bronchodilator that has a spasmodic effect on the working bronchial muscles. It helps to dilate the bronchi and make breathing easier.

Parasympatholytic drug

The pharmacological action of Berodual is provided by two active components.

Ipratropium bromide exhibits an anticholinergic effect, fenoterol hydrobromide has an adrenergic effect, respectively.

Pharmacological effect
The combination of ingredients included in Berodual potentiates the bronchodilator effect, ensuring its prolongation. Each individually has an excellent mechanism and location of action:

Ipratropium bromide blocks cholinergic receptors. Perfectly eliminating bronchospasm caused by the action vagus nerve, reduces the secretory secretion of bronchial and other glands.
Fenoterol is involved in the activation of the formation of c-AMP, which stimulates the function of the calcium pump. The result is a decrease in the quantitative indicators of calcium in the organelles responsible for the contraction of striated muscles, and delatation (dilation) of the bronchi.

Release form

This drug is a new generation medicine. It has two release forms:

A dosed container (or nebulizer) with a volume of 15 ml, having a dosing valve designed for 300 doses. In one dose, along with active active ingredients, injected lemon acid, which has bactericidal and antioxidant properties.
Composition for inhalation. Available in a 20 ml bottle.

Basic information

The therapeutic result of the medication is noticeable within a few minutes after use. The maximum effect is achieved after several hours and lasts about 6 hours.

Indications

This medicine can be prescribed for a number of diseases, including:

laryngitis, pneumonia, tracheitis and other respiratory diseases, accompanied by a persistent, debilitating cough;
asthma;
obstructive syndrome and its prevention in tuberculosis;
bronchospasm in diseases of the upper and lower respiratory organs;
emphysema.

Contraindications

To avoid undesirable results from irrational use, it is not recommended to take the medicine without a doctor’s prescription. This is also due to the presence of contraindications. Among them:

individual intolerance to components;
tachyarrhythmia or pathology of fast heartbeat;
period after myocardial infarction;
CVD diseases: ischemia, coronary vascular insufficiency;
increased blood pressure;
angle-closure glaucoma;
dysfunction thyroid gland, among them hyperthyroidism;
lesions and infections of the bladder neck;
diabetes;
children under 6 years of age.

Side effects

Risk of manifestation side effect from taking this drug is increased, to a greater extent, in younger children, especially infancy. This is due to the tendency to allergic manifestations on active substances. Among side effects the following are observed:

dryness of the nasopharyngeal mucosa;
reflex contraction of some muscles;
dizziness and temporal pain;
increased blood pressure;
increased heart rate;
nausea and vomiting;
irritation of the respiratory tract, accompanied by cough;
rashes, urticaria;
excessive sweating;
lethargy.

It is important to know that if a child has heat, commit inhalation procedures You can't use a nebulizer.

The child may experience shortness of breath. In such a situation, you should urgently call a team of specialists.

In case of burning and hyperemia of the sclera of the eyes, flashing of colored spots before the eyes, it is necessary to use drops that have a vasoconstrictor effect in order to avoid the appearance of closed-angle glaucoma. Then be sure to consult an ophthalmologist.

Medication Compatibility

When combining the drug with other drugs with adrenergic and anticholinergic effects, great care must be taken when calculating dosages. Moreover, this is done with the consent of the attending physician. Otherwise, an increased bronchodilator effect is possible.

With caution, it is necessary to prescribe Brodual with xanthine derivatives, diuretics, steroids to people who have obstructive diseases respiratory organs. Because there is a risk of developing hypokalemia, which can provoke arrhythmia and other complications.

Possible causes and manifestations of toxemia

Brodual - quite serious medicine, affecting a number of organs and systems of the body. When a patient notices that the usual norm does not bring the same result, he should seek recommendations from his doctor. Independent dose increases are not allowed.

Rules of application

This product is used for inhalation only. For these purposes it is used compressor inhaler or a nebulizer.

The use of steam inhalers is strictly prohibited.

Aerosol

Doses and treatment algorithms are developed by the doctor based on the diagnosis, the patient’s age and his individual reaction to the ingredients of the drug. For young children (under 6 years old), the product is allowed exclusively in the form of saline solution under the strict supervision of a pediatrician.

For children age group over 6 years of age, the smallest therapeutic dose is usually considered to be 1-2 inhalations at a time, which corresponds to 1-2 presses.

If relief does not occur after 5 minutes, 2 more inhalation doses are allowed. But you cannot make more than 4 clicks at one time.

Solution

The mixture for inhalation should be prepared immediately before use. Its storage and use of the remaining composition is not allowed.

The composition must be poured into a nebulizer and inhaled. The process continues until the liquid evaporates completely. Typically this can correspond to 6-7 minutes.

After the procedure, you should rinse your mouth. Eating is allowed at least 60 minutes after the procedure.

The course of treatment often lasts 5-10 days, depending on the diagnosis.

Age categories

Unless otherwise prescribed by the attending physician, the medicine should be used according to the instructions:

For ages from 2 to 6 years (weighing less than 22 kg), with careful supervision by a pediatrician, 0.5 ml (10 drops) three times a day is recommended. Maximum daily norm no more than 1.5 ml.
For ages 6 to 12 years, 0.5-1 ml is recommended, but not more than 3 ml/day. During course therapy, 4 ml of the daily dose is allowed.
For those over 12 years of age, including adults, 1-2 ml three or four times a day is recommended. But no more than 8 ml of the permissible daily intake.

Intoxication

If there is an overdose of berodual, the symptoms are often associated, to a large extent, with the influence of fenoterol. In case of an overdose of Berodual, the symptoms will be as follows:

Symptoms provoked by the influence of ipratropium bromide are mild. This is due to a wide range of therapeutic norms and local use. Signs of overdose in this case are characterized by:

excessive dryness of the oral mucosa;
impaired visual function (accommodation).

Giving help

If drug poisoning occurs, everyone should know what to do. After all, this remedy is not for oral administration, when in case of intoxication it is necessary to rinse the gastrointestinal tract. In this case, this procedure is not advisable.

Specific therapy

The first thing to do is stop using the medicine and call a team of professionals. Because in such a situation, professional help is justified in 100% of cases.

Treatment begins with the introduction of an antidote, which are cardioselective β-blockers. Among them are atenolol, betaxol, and Sectral. They are prescribed with great caution, carefully selecting doses. This is due to the risk of increasing the severity of closure of the bronchial lumen.

Symptomatic therapy

Additional procedures are aimed at eliminating accompanying symptoms. In addition, they are aimed at preventing the development and restoration of the functions of the cardiovascular system and respiratory system. Among them:

Inhalation of humidified oxygen in case of respiratory failure. An increase in respiratory failure gives rise to transfer of the patient to artificial ventilation of the lungs. To relieve paradoxical bronchospasm, anticholinergic and antispasmodic drugs are prescribed. If necessary (according to indications), corticosteroid hormonal drugs (dexamethasole or prednisolone) and/or antihistamines are prescribed.
Subcutaneous administration of 2% papaverine hydrochloride solution, intramuscular injection 2.5% aminazine solution or intravenous administration of 2.4% aminophylline solution, for high blood pressure.
Prescription of tranquilizers (Relanium) in case of psychomotor agitation.
Intravenous administration or oral administration of diacarb, topical pilocarpine solution, etc., if there is a risk of angle-closure glaucoma.
Required resuscitation measures when breathing and cardiac arrest stop.

Possible consequences

If the overdose occurred in mild form, and help was provided on time, then danger signs pass within a day and without further consequences.