Salmeterol

Salmeterol is a highly selective, inhaled β 2-agonist indicated for the long-term treatment of asthma and for prevention of bronchospasm in adults with reversible obstructive airway disease. Stimulation of β 2 -receptors by it in the lung causes relaxation of bronchial smooth muscle, which produces bronchodilation and a resultant increase in bronchial airflow. Compared with other inhaled β-2 agonists, it has a longer duration of action, which allows for twice-daily dosing; however, onset of therapeutic effects is prolonged, which limits the usefulness of it. Because of its delayed onset, it should never be used to treat an acute attack. It is, however, very effective for prophylactic therapy. It was approved by the FDA in February 1994.

Brands
SEREVENT SERETIDE EVOHALER SERETIDE EVOHALER SERETIDE EVOHALER AXINAT SALMICORT SALMICORT SALMICORT
Adult Dose
Dose: 25 to 50 mcg
Single Dose: 38 (37.5)
Frequency: 12 hourly
Route: Inhalation
Instructions:
Neonatal
Paedriatic
Dose: 2 ug/kg
Single Dose: 2 (2)
Frequency: 12 hourly
Route: Inhalation
Instructions: Dose for Childrens 5-12 Yrs. Age
Characteristics
. It is of Synthetic origin and belongs to Nephthoate. It belongs to Beta-2 adrenergic agonist pharmacological group on the basis of mechanism of action and also classified in Bronchodilator pharmacological group.The Molecular Weight of Salmeterol is 603.70.
Contraindications
Salmeterol is contraindicated in conditions like Hypertension,Hypersensitivity.
Effects
The severe or irreversible adverse effects of Salmeterol, which give rise to further complications include Cardiac arrhythmias, Atrial fibrillation, Extrasystoles, Tremors, Supraventricular tachycardia.The symptomatic adverse reactions produced by Salmeterol are more or less tolerable and if they become severe, they can be treated symptomatically, these include Headache, Myalgia, Palpitation, Tachycardia, Nervousness, Rashes, Hypersensitivity reactions, Pharyngitis, Cough, Arthralgia, Edema, Backache, Angioedema, BP variations.
Indications
Salmeterol is primarily indicated in conditions like Chronic bronchitis, Chronic obstructive pulmonary disease, Exercise-induced asthma, Obstructive airway disease, Oedema, Oliguria due to renal failure, and can also be given in adjunctive therapy as an alternative drug of choice in Asthma, Severe airways obstruction.
Interactions
Salmeterol is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAminophyllineConcurrent use may potentiate the risk of adverse effects.AtazanavirConcurrent use may potentiate the risk of cardiovascular adverse events.BambuterolClarithromycinConcurrent use may potentiate the risk of cardiovascular adverse events.Indinavir (Sulphate)Concurrent use may potentiate the risk of cardiovascular adverse events.KetoconazoleCoadministration of salmeterol (50 mcg twice daily) and ketoconazole (400 mg once daily) for 7 days resulted in greater systemic exposure to salmeterol.Nefazodone (HCl)Concurrent use may potentiate the risk of cardiovascular adverse events.PhenelzineAction of salmeterol on the vascular system may be potentiated by Phenelzine. RitonavirConcurrent use may potentiate the risk of cardiovascular adverse events.SaquinavirConcurrent use may potentiate the risk of cardiovascular adverse events.Selegiline (HCl)Action of salmeterol on the vascular system may be potentiated by Selegiline (HCl). TheophyllineConcurrent use may potentiate the risk of adverse effects.Tranylcypromine (Sulphate)Action of salmeterol on the vascular system may be potentiated by Tranylcypromine (Sulphate). VORICONAZOLEVoriconazole may increase the serum concentration of salmeterol by decreasing its metabolism. Consider alternate therapy These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to Pregnant Mothers, and Cardiac / Hypertensive Patients.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inhaler Store at room temperature, Below 30°C or in refrigerator. Do not Freeze. Protect from Sunlight, Moisture and Heat.
Warnings
Salmeterol should be used with caution in patients with heart disease including heart ischemic heart disease, arrhythmias, pheochromocytoma, unusual responsiveness to other sympathomimetics amines, high blood pressure, hyperthyroidism, seizures disorders, diabetes or any drug allergy. It should be used with caution during pregnancy and only if the benefits of therapy outweigh the risk to the fetus.
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