PulmoCare 100mcg Metered-Dose Inhaler (Refill)

PulmoCare Inhaler is used for:

1. Bronchospasm: It treats or prevents bronchospasm in bronchial asthma and reversible airway obstruction related to conditions such as bronchitis and emphysema.
2. Exercise-Induced Bronchospasm: PulmoCare is effective in relieving acute breathlessness (dyspnoea) and can also be used prophylactically, taken 15 minutes before exercise or exposure to allergens to prevent exercise-induced asthma.

Pharmacology:

The active ingredient in PulmoCare Inhaler is Salbutamol, a selective β2-adrenoceptor agonist.

• It primarily targets the β2-receptors on bronchial smooth muscles, causing bronchodilation and improving airflow in conditions like asthma.
• Salbutamol has a fast onset (within 5 minutes) and provides short-acting relief (lasting 4-6 hours).
• It also helps in reducing inflammation by inhibiting the release of mediators like histamine, neutrophil chemotactic factor, and prostaglandin D2 from mast cells, which are responsible for bronchoconstriction.

Dosage:

For Acute Bronchospasm Relief:

• Adults: 1-2 puffs as needed. The maximum dose is up to 8 puffs per day.
• Children: Half the adult dose.

To Prevent Exercise-Induced Bronchospasm:

• Adults: 2 puffs 15 minutes before exercise or allergen exposure, up to 4 times a day.
• Children: Half the adult dose.

Chronic Therapy:

• Adults: 2 puffs (200 mcg) up to four times daily.
• Children: 2 puffs (200 mcg) up to four times daily.

Always follow the physician’s instructions for proper dosage.

Administration:

Correct inhaler technique is essential for proper drug delivery to the lungs. Follow these steps:

1. Remove the cap from the inhaler.
2. Shake the inhaler vigorously at least 6 times before each use.
3. If the inhaler is new or hasn’t been used for over a week, shake it and release one puff into the air to ensure it works.
4. Exhale fully, hold the inhaler upright, and place the mouthpiece between your teeth, closing your lips around it.
5. Inhale deeply and slowly while pressing the canister firmly to release the medicine.
6. Hold your breath for at least 10 seconds, or as long as comfortable.
7. If more than one puff is required, wait 1 minute between puffs.
8. After use, replace the cap and rinse your mouth with water.
9. Cleaning: Clean the inhaler weekly by removing the canister, rinsing the actuator and cap in warm water (not the canister), and letting them dry before reassembling.

Drug Interactions:

• Non-selective Beta-blockers (e.g., Propranolol): Should be avoided with PulmoCare as they may antagonize the effects of Salbutamol.
• Potential for Hypokalemia: β2-agonists may cause low potassium levels, especially when combined with xanthine derivatives, steroids, diuretics, or hypoxia. Monitor serum potassium levels in such cases.

Contraindications:

• Hypersensitivity: Do not use in patients allergic to Salbutamol or other components of the inhaler.

Side Effects:

PulmoCare is generally well tolerated, but some side effects may occur:

• Tremors, anxiety, and muscle cramps.
• Headaches, palpitations, and tachycardia (increased heart rate).
• Cardiac arrhythmias (like atrial fibrillation, supraventricular tachycardia, and extrasystoles).
• Mouth and throat irritation from inhalation.

Pregnancy & Lactation:

• Pregnancy Category C: PulmoCare should be used during pregnancy only if the benefit outweighs the risk to the fetus, as there are no adequate studies in pregnant women.
• Lactation: It is unknown whether Salbutamol passes into breast milk, so it should be used cautiously in nursing mothers.

Precautions & Warnings:

Paradoxical Bronchospasm: Rarely, PulmoCare may cause paradoxical bronchospasm, which can be life-threatening. If this occurs, discontinue the inhaler immediately and seek alternative therapy.

Cardiovascular Effects: Salbutamol may cause changes in heart rate, blood pressure, and ECG changes (like flattened T waves and QT interval prolongation). Use with caution in patients with heart disease, arrhythmias, or hypertension.

Hypersensitivity: Immediate reactions such as urticaria, angioedema, and anaphylaxis may occur. Discontinue if these occur.

Coexisting Conditions: Use cautiously in patients with diabetes, hyperthyroidism, or seizure disorders. High doses may worsen diabetes and ketoacidosis.

Special Populations:

• Children: PulmoCare is effective and safe in children 4 years and older.

Therapeutic Class:

PulmoCare is classified as a short-acting selective β2-adrenoceptor stimulant.

Storage Conditions:

• Store below 30°C, and keep away from heat, sunlight, and moisture.
• Do not puncture, break, or burn the pressurized canister, even when empty.
• Keep out of reach of children and store away from eyes.
• Do not freeze.