Stimulation of the vagus nerve

Registration number:

Trade name of the drug:

International Nonproprietary Name:

Dosage Form:

1 ml solution for inhalation contains: active substance: 261 µg ipratropium bromide monohydrate, in terms of anhydrous ipratropium bromide (250 µg) and 500 µg fenoterol hydrobromide. excipients: benzalkonium chloride, disodium edetate dihydrate, sodium chloride, 1N hydrochloric acid, purified water

Stimulation of the vagus nerveA clear, colorless or almost colorless liquid, free from suspended particles. The smell is almost imperceptible.

Pharmacotherapeutic group:

Combined bronchodilator (ß2-adrenergic selective + m-holinoblokator)

Stimulation of the vagus nerve

Pharmacological properties

Pharmacodynamics Berodual contains two components with bronchodilatory activity: ipratropium bromide – m-cholinoblocker, and fenoterol – ß2-adrenomimetic. Bronchodilation with inhalation ipratropium bromide is mainly due to local, rather than systemic, anticholinergic effects. Ipratropium bromide is a quaternary ammonium derivative with anticholinergic (parasympatholytic) properties. The drug inhibits the reflexes caused by the vagus nerve, counteracting the effects of acetylcholine, a mediator released from the endings of the vagus nerve. Anticholinergics prevent an increase in the intracellular concentration of Ca ++, which occurs as a result of the interaction of acetylcholine with the muscarinic receptor located on the smooth muscles of the bronchi. The release of Ca ++ is mediated by a system of secondary mediators, including ITP (inositol triphosphate) and DAG (diacylglycerol). In patients with bronchospasm associated with chronic obstructive pulmonary diseases (chronic bronchitis and pulmonary emphysema), a significant improvement in lung function (increase in forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate by 15% or more) was observed within 15 minutes, the maximum effect was achieved in 1-2 hours and lasted for most patients until 6 hours after administration. Ipratropium bromide does not adversely affect the secretion of mucus in the respiratory tract, mucociliary clearance and gas exchange. Fenoterol selectively stimulates β2-adrenoreceptors in a therapeutic dose. The stimulation of ß1-adrenoreceptors occurs when using high doses. Fenoterol relaxes the smooth muscles of the bronchi and blood vessels and counteracts the development of bronchospastic reactions caused by the effect of histamine, methacholine, cold air and allergens (immediate type hypersensitivity reactions). Immediately after administration, fenoterol blocks the release of inflammatory mediators and bronchial obstruction from mast cells. In addition, when using fenoterol in doses of

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