Для постоянного применения в качестве поддерживающей терапии бронхиальной астмы, в т.ч. для уменьшения тяжести обострений бронхиальной астмы у взрослых и детей в возрасте старше 12 лет: пациентам, которым не удается контролировать течение заболевания, применяя только ингаляционные ГКС и ингаляционные бета2-адреномиметики короткого действия для купирования приступов (в режиме "по потребности"); пациентам, тяжесть заболевания у которых требует назначения двух видов поддерживающей терапии.
Противопоказания
Детский возраст до 12 лет; повышенная чувствительность к активным веществам.
С осторожностью
Пациенты с туберкулезом или латентной туберкулезной инфекцией, а также с нелеченными грибковыми, бактериальными, системными вирусными заболеваниями или простым герпесом с поражением глаз, с ИБС, нарушениями сердечного ритма (особенно AV-блокадой III степени), ...
Препарат Зенхейл показан в качестве препарата для постоянного применения для поддерживающей терапии бронхиальной астмы, в т.ч. для уменьшения тяжести обострений бронхиальной астмы у взрослых и детей в возрасте старше 12 лет
Мометазона фуроат – ГКС, обладающий местным противовоспалительным действием. Мометазона фуроат значительно ингибирует высвобождение лейкотриенов из лейкоцитов. В культуре клеток мометазона фуроат выраженно ингибирует синтез и высвобождение ИЛ-1, ИЛ-5, ИЛ-6 и ФНОα и является мощным ингибитором продукции ТH2 цитокинов, ИЛ-4 и ИЛ-5 в человеческих CD4+ Т-клетках.
Формотерол является сильным селективным бета2-адреномиметиком. В среднем бронходилатирующий эффект у пациентов с обратимой бронхообструкцией длится 12 ч. Формотерол ингибирует высвобождение гистамина и лейкотриенов в ткани легкого. В доклинических исследованиях были показаны некоторые противовоспалительные свойства, такие как ингибирование развития отека и накопления клеток воспаления.
Показания к применению
Для постоянного применения в качестве поддерживающей терапии бронхиальной астмы, в т.ч. для уменьшения тяжести обострений бронхиальной астмы у взрослых и детей в возрасте старше 12 лет: пациентам, которым не удается контролировать течение заболевания, применяя только ингаляционные ГКС и ингаляционные бета2-адреномиметики короткого действия для купирования приступов (в режиме "по потребности"); пациентам, тяжесть заболевания у которых требует назначения двух видов поддерживающей терапии.
Противопоказания
Детский возраст до 12 лет; повышенная чувствительность к активным веществам.
С осторожностью
Пациенты с туберкулезом или латентной туберкулезной инфекцией, а также с нелеченными грибковыми, бактериальными, системными вирусными заболеваниями или простым герпесом с поражением глаз, с ИБС, нарушениями сердечного ритма (особенно AV-блокадой III степени), выраженной хронической сердечной недостаточностью, идиопатическим гипертрофическим субаортальным стенозом, артериальной гипертензией тяжелой степени, аневризмой, феохромоцитомой, гипертрофической обструктивной кардиомиопатией, тиреотоксикозом, удлинением интервала QT (QT скорректированный > 0.44 сек); пациенты, которых переводят с системной терапии ГКС на ингаляционную терапию.
Способ применения и дозы
Способ применения и режим дозирования конкретного препарата зависят от его формы выпуска и других факторов. Оптимальный режим дозирования определяет врач. Следует строго соблюдать соответствие используемой лекарственной формы конкретного препарата показаниям к применению и режиму дозирования.
Ингаляционно. Режим дозирования индивидуальный, в зависимости от показаний, возраста пациента и клинической ситуации.
Побочное действие
Со стороны нервной системы: головная боль, тремор, головокружение.
Со стороны органа зрения: поражения хрусталика, повышение внутриглазного давления.
Со стороны нервной системы: бессонница, нервозность, тревожность, возбуждение.
Со стороны сердечно-сосудистой системы: тахикардия, ощущение сердцебиения, повышение АД.
Со стороны дыхательной системы: дисфония, боли в ротоглотке, раздражение глотки.
Со стороны пищеварительной системы: тошнота, сухость во рту, кандидоз ротовой полости, диспепсия, повышение массы тела.
Со стороны костно-мышечной системы: мышечные спазмы.
Системные реакции: угнетение гипоталамо-гипофизарно-надпочечниковой системы, задержка роста у детей и подростков, деминерализация костей, стероидный диабет.
Особые указания
Стрессовые ситуации, такие как травмы, операции, инфекционные заболевания или приступы бронхиальной астмы, могут потребовать назначения короткого курса заместительной терапии системными ГКС, которые впоследствии будет необходимо отменить, постепенно снижая их дозу по мере исчезновения симптомов. Таким пациентам рекомендуется всегда иметь при себе запас ГКС в форме таблеток и информационную карточку, в которой указано, что пациенту в стрессовых ситуациях необходим прием ГКС перорально и рекомендованные дозы. Также этой группе пациентов рекомендован периодический контроль функции коры надпочечников, в частности, измерение уровня кортизола в плазме в утренние часы.
Перевод пациентов с системной терапии ГКС на ингаляционную может привести к проявлению ранее существовавших симптомов некоторых аллергических заболеваний, которые были скрыты на фоне предшествующей системной ГКС терапии. В таких случаях показано симптоматическое лечение.
Пациенты должны быть обучены врачом или медицинским персоналом правилам пользования.
На фоне применения лекарственного средства могут развиться серьезные побочные эффекты и осложнения, связанные с бронхиальной астмой. Пациентам не следует прерывать курс лечения, однако в случае отсутствия контроля заболевания или усиления симптомов следует немедленно обратиться к врачу.
Не следует начинать лечение у пациентов при резком нарастании симптомов бронхиальной астмы, а также при жизнеугрожающих обострениях.
Врач должен пересмотреть терапию бронхиальной астмы, если симптомы бронхиальной астмы персистируют, если для достижения контроля заболевания требуется постоянное увеличение дозы препарата, если бронходилататоры более не купируют приступы бронхиальной астмы или если снижается пиковая скорость выдоха, поскольку эти признаки обычно свидетельствуют об ухудшении течения бронхиальной астмы. В вышеперечисленных случаях следует рассмотреть возможность использования дополнительной терапии ГКС.
Не является средством для быстрого купирования бронхоспазма или каких-либо других проявлений приступа бронхиальной астмы. В таких случаях следует применять бета2-адреномиметики короткого действия. Помимо этого, пациент должен быть проинформирован о необходимости незамедлительного обращения к врачу в случае ухудшения течения бронхиальной астмы.
Во время проведения клинических исследований у некоторых пациентов было отмечено развитие кандидоза ротоглотки, связанное с приемом ГКС. Такого рода осложнение, как правило, требует специального курса лечения противогрибковыми препаратами, а в некоторых случаях и отмены препарата. Пациенту следует посоветовать полоскание рта после применения препарата.
Случаи развития катаракты и глаукомы на фоне приема мометазона фуроата описываются редко.
На фоне применения бета2-адреномиметиков возможно развитие серьезной гипокалиемии. Гипокалиемия может повысить вероятность развития аритмии.
С осторожностью следует относиться к пациентам с тяжелой степенью бронхиальной астмы, поскольку развитие гипокалиемии может потенцироваться гипоксией и сопутствующим лечением. В таких ситуациях рекомендуется проводить постоянный мониторинг уровня сывороточного калия.
Бета2-адреномиметики, в т.ч. и формотерол, обладают гипергликемическим эффектом, поэтому пациентам с сахарным диабетом рекомендуется дополнительный мониторинг содержания глюкозы в крови.
Влияние на способность к управлению транспортными средствами и механизмами
При развитии побочных эффектов со стороны нервной системы следует воздержаться от управления автомобилем или работы с механизмами в период приема препарата.
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Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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Зенхейл показан в качестве препарата для постоянного применения для поддерживающей терапии бронхиальной астмы, в т.ч. для уменьшения тяжести обострений бронхиальной астмы у взрослых и детей в возрасте старше 12 лет"}}]},{"id":5,"name":"Фармакотерапевтическая группа","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.vidal.ru/drugs/clinic-group/327\"\u003eПрепарат с противовоспалительным и бронхолитическим действием\u003c/a\u003e"}}]},{"id":6,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"Бронходилатирующее комбинированное средство."}},{"type":"paragraph","data":{"text":"\u003ci\u003eМометазона фуроат\u003c/i\u003e – ГКС, обладающий местным противовоспалительным действием. Мометазона фуроат значительно ингибирует высвобождение лейкотриенов из лейкоцитов. В культуре клеток мометазона фуроат выраженно ингибирует синтез и высвобождение ИЛ-1, ИЛ-5, ИЛ-6 и ФНОα и является мощным ингибитором продукции ТH2 цитокинов, ИЛ-4 и ИЛ-5 в человеческих CD4+ Т-клетках."}},{"type":"paragraph","data":{"text":"\u003ci\u003eФормотерол\u003c/i\u003e является сильным селективным бета\u003csub\u003e2\u003c/sub\u003e-адреномиметиком. В среднем бронходилатирующий эффект у пациентов с обратимой бронхообструкцией длится 12 ч. Формотерол ингибирует высвобождение гистамина и лейкотриенов в ткани легкого. В доклинических исследованиях были показаны некоторые противовоспалительные свойства, такие как ингибирование развития отека и накопления клеток воспаления."}}]},{"id":7,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":" Для постоянного применения в качестве поддерживающей терапии бронхиальной астмы, в т.ч. для уменьшения тяжести обострений бронхиальной астмы у взрослых и детей в возрасте старше 12 лет: пациентам, которым не удается контролировать течение заболевания, применяя только ингаляционные ГКС и ингаляционные бета\u003csub\u003e2\u003c/sub\u003e-адреномиметики короткого действия для купирования приступов (в режиме \"по потребности\"); пациентам, тяжесть заболевания у которых требует назначения двух видов поддерживающей терапии. "}}]},{"id":8,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Детский возраст до 12 лет; повышенная чувствительность к активным веществам."}},{"type":"paragraph","data":{"text":"\u003ci\u003eС осторожностью\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Пациенты с туберкулезом или латентной туберкулезной инфекцией, а также с нелеченными грибковыми, бактериальными, системными вирусными заболеваниями или простым герпесом с поражением глаз, с ИБС, нарушениями сердечного ритма (особенно AV-блокадой III степени), выраженной хронической сердечной недостаточностью, идиопатическим гипертрофическим субаортальным стенозом, артериальной гипертензией тяжелой степени, аневризмой, феохромоцитомой, гипертрофической обструктивной кардиомиопатией, тиреотоксикозом, удлинением интервала QT (QT скорректированный > 0.44 сек); пациенты, которых переводят с системной терапии ГКС на ингаляционную терапию."}}]},{"id":11,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСпособ применения и режим дозирования конкретного препарата зависят от его формы выпуска и других факторов. Оптимальный режим дозирования определяет врач. Следует строго соблюдать соответствие используемой лекарственной формы конкретного препарата показаниям к применению и режиму дозирования.\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Ингаляционно. Режим дозирования индивидуальный, в зависимости от показаний, возраста пациента и клинической ситуации."}}]},{"id":12,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны нервной системы: \u003c/i\u003eголовная боль, тремор, головокружение."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны органа зрения: \u003c/i\u003eпоражения хрусталика, повышение внутриглазного давления."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАллергические реакции: \u003c/i\u003eбронхоспазм, атопический дерматит, крапивница."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны нервной системы: \u003c/i\u003eбессонница, нервозность, тревожность, возбуждение."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны сердечно-сосудистой системы: \u003c/i\u003eтахикардия, ощущение сердцебиения, повышение АД."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны дыхательной системы: \u003c/i\u003eдисфония, боли в ротоглотке, раздражение глотки."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны пищеварительной системы: \u003c/i\u003eтошнота, сухость во рту, кандидоз ротовой полости, диспепсия, повышение массы тела."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны костно-мышечной системы: \u003c/i\u003eмышечные спазмы."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСистемные реакции\u003c/i\u003e: угнетение гипоталамо-гипофизарно-надпочечниковой системы, задержка роста у детей и подростков, деминерализация костей, стероидный диабет."}}]},{"id":15,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Стрессовые ситуации, такие как травмы, операции, инфекционные заболевания или приступы бронхиальной астмы, могут потребовать назначения короткого курса заместительной терапии системными ГКС, которые впоследствии будет необходимо отменить, постепенно снижая их дозу по мере исчезновения симптомов. Таким пациентам рекомендуется всегда иметь при себе запас ГКС в форме таблеток и информационную карточку, в которой указано, что пациенту в стрессовых ситуациях необходим прием ГКС перорально и рекомендованные дозы. Также этой группе пациентов рекомендован периодический контроль функции коры надпочечников, в частности, измерение уровня кортизола в плазме в утренние часы."}},{"type":"paragraph","data":{"text":"Перевод пациентов с системной терапии ГКС на ингаляционную может привести к проявлению ранее существовавших симптомов некоторых аллергических заболеваний, которые были скрыты на фоне предшествующей системной ГКС терапии. В таких случаях показано симптоматическое лечение."}},{"type":"paragraph","data":{"text":"Пациенты должны быть обучены врачом или медицинским персоналом правилам пользования."}},{"type":"paragraph","data":{"text":"На фоне применения лекарственного средства могут развиться серьезные побочные эффекты и осложнения, связанные с бронхиальной астмой. Пациентам не следует прерывать курс лечения, однако в случае отсутствия контроля заболевания или усиления симптомов следует немедленно обратиться к врачу."}},{"type":"paragraph","data":{"text":"Не следует начинать лечение у пациентов при резком нарастании симптомов бронхиальной астмы, а также при жизнеугрожающих обострениях."}},{"type":"paragraph","data":{"text":"Врач должен пересмотреть терапию бронхиальной астмы, если симптомы бронхиальной астмы персистируют, если для достижения контроля заболевания требуется постоянное увеличение дозы препарата, если бронходилататоры более не купируют приступы бронхиальной астмы или если снижается пиковая скорость выдоха, поскольку эти признаки обычно свидетельствуют об ухудшении течения бронхиальной астмы. В вышеперечисленных случаях следует рассмотреть возможность использования дополнительной терапии ГКС."}},{"type":"paragraph","data":{"text":"Не является средством для быстрого купирования бронхоспазма или каких-либо других проявлений приступа бронхиальной астмы. В таких случаях следует применять бета\u003csub\u003e2\u003c/sub\u003e-адреномиметики короткого действия. Помимо этого, пациент должен быть проинформирован о необходимости незамедлительного обращения к врачу в случае ухудшения течения бронхиальной астмы."}},{"type":"paragraph","data":{"text":"Во время проведения клинических исследований у некоторых пациентов было отмечено развитие кандидоза ротоглотки, связанное с приемом ГКС. Такого рода осложнение, как правило, требует специального курса лечения противогрибковыми препаратами, а в некоторых случаях и отмены препарата. Пациенту следует посоветовать полоскание рта после применения препарата."}},{"type":"paragraph","data":{"text":"Случаи развития катаракты и глаукомы на фоне приема мометазона фуроата описываются редко."}},{"type":"paragraph","data":{"text":"На фоне применения бета\u003csub\u003e2\u003c/sub\u003e-адреномиметиков возможно развитие серьезной гипокалиемии. Гипокалиемия может повысить вероятность развития аритмии."}},{"type":"paragraph","data":{"text":"С осторожностью следует относиться к пациентам с тяжелой степенью бронхиальной астмы, поскольку развитие гипокалиемии может потенцироваться гипоксией и сопутствующим лечением. В таких ситуациях рекомендуется проводить постоянный мониторинг уровня сывороточного калия."}},{"type":"paragraph","data":{"text":"Бета\u003csub\u003e2\u003c/sub\u003e-адреномиметики, в т.ч. и формотерол, обладают гипергликемическим эффектом, поэтому пациентам с сахарным диабетом рекомендуется дополнительный мониторинг содержания глюкозы в крови."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВлияние на способность к управлению транспортными средствами и механизмами\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"При развитии побочных эффектов со стороны нервной системы следует воздержаться от управления автомобилем или работы с механизмами в период приема препарата."}}]}],"source":{"title":"ЗдравСити","url":"https://zdravcity.ru"}},"description_toggle":false,"short_description":"Бронходилатирующее комбинированное средство.Мометазона фуроат– ГКС, обладающий местным противовоспалительным действием. 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