Freeway inhalation solution is intended for use as a bronchodilator in the maintenance therapy of bronchospasm in chronic obstructive pulmonary diseases (COPD), including chronic bronchitis and emphysema of the lungs, as well as in bronchial asthma.
Frivei Combi Pharmacological properties
Freeway Combi contains two active bronchodilator ingredients: ipratropium bromide, which has an anticholinergic effect, and fenoterol hydrobromide, which is a β-adrenergic agonist.
Ipratropium bromide is a quaternary ammonium compound with anticholinergic (parasympatholytic) properties. It inhibits vagal reflexes by antagonizing acetylcholine, a neurotransmitter that mediates the impulse of the vagus nerve. Anticholinergics prevent an increase in intracellular Ca ++ concentration resulting from the interaction of acetylcholine with smooth muscle muscarinic receptors. The release of Ca ++ is facilitated by another system of mediators, which consists of IP3 (inositol triphosphate) and DAG (diacylglycerol).
The expansion of the bronchi after inhalation of ipratropium bromide is mainly due to the local specific effect of the drug, which is not systemic.
Fenoterol hydrobromide is a direct sympathomimetic that selectively stimulates beta2-adrenergic receptors in the therapeutic range. When used in higher doses, beta1-adrenergic receptors are stimulated. The binding of β2-adrenergic receptors using the activating Gs-protein leads to the activation of adenylate cyclase. With an increase in the level of cyclic AMP, protein kinase A is activated and the corresponding proteins are phosphorylated in smooth muscle cells. In turn, this leads to phosphorylation of myosin light chain kinase, blocking the hydrolysis of phosphoinositide, and opening large calcium-dependent potassium channels.
Frivei Combi Indications
Prevention and symptomatic treatment of chronic obstructive airway disorders: allergic and non-allergic (endogenous) BA; exercise-induced BA and chronic obstructive bronchitis with and without emphysema.
With long-term therapy, it is necessary to prescribe concomitant anti-inflammatory therapy.
Frivei Combi Application
For inhalation with a nebulizer only.
Treatment should be started and carried out under the supervision of a physician, for example, in a hospital setting.
Treatment at home, after consultation with an experienced physician, may be recommended for patients in whom the use of low-dose, rapid-acting β-agonists has not been sufficient to alleviate the condition. Home treatment can also be recommended for patients who need to use a nebulizer for other reasons (for example, due to problems with the use of aerosols). Or because of the need to obtain higher doses for patients who are familiar with the rules for using the nebulizer.
Therapy should always be started at the lowest recommended dose.
The dose should be selected individually depending on the severity of the acute episode.
Use should be stopped when symptom relief has been achieved.
The inhalation solution is intended for inhalation only with an appropriate nebulizer and should not be taken orally.
For use, the recommended dose must be diluted with physiological solution (0.9%) to a final volume of 3-4 ml. 1 ml of Freeway Combi inhalation solution contains 20 drops. The diluted, ready-to-use solution should be inhaled until sufficient relief of symptoms is achieved.
The diluted ready-to-use solution must be freshly prepared each time before use. The ready-to-use solution should be used immediately after preparation; any remnants of the diluted solution must be destroyed. Patients should follow the instructions of the nebulizer manufacturer.