NAOS ® - Salbutamol + Ipratropium bromide

NAOS ® is a drug based on Salbutamol sulfate and Ipratropium bromide

THERAPEUTIC GROUP: Adrenergics for aerosols and other drugs for obstructive airway syndromes

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications NAOS ® - Salbutamol + Ipratropium bromide

NAOS ® is indicated for the treatment of bronchial asthma and chronic obstructive bronchopathy with asthmatic component.

Mechanism of action NAOS ® - Salbutamol + Ipratropium bromide

NAOS ® is a medicinal specialty, used in the treatment of obstructive pathologies of the respiratory tract such as asthma and chronic obstructive bronchopathy with asthmatic component, constituted by two important active principles, endowed with different biological activities, however both characterized by the bronchodilator action.

More precisely, the Salbutamol is a direct sympathomimetic drug, able to interact with the Beta 2 Adrenergic receptors, expressed by bronchial smooth muscle, determining, through different molecular mechanisms, a relaxation of the same, while the Ipratropium bromide, interacting and blocking the receptors Muscarinic m2 and M3 expressed by bronchial smooth muscle, determines a bronchodilation that persists for a few hours.

These two mechanisms, which intervene in the different phases of bronchoconstriction, guarantee a restoration of normal airway patency with a clear improvement in the complained symptomatology.

Everything is facilitated by the inhalation route, which significantly reduces the risk of clinically relevant side effects

Studies carried out and clinical efficacy

BROMUROUS AND ALBUTEROL IPRATROPIO IN COPD

Int J Chron Obstruct Pulmon Dis. 2013; 8: 221-30. doi: 10.2147 / COPD.S31246. Epub 2013 Apr 30.

Panos RJ.

Study demonstrating the efficacy of the combined Ipratropio bromide and Albuterol treatment in improving the clinical condition of COPD patients, resulting in reduced morbidity.

SAFETY OF COMBINED THERAPY

Pulm Pharmacol Ther. 2013 Oct; 26 (5): 574-80. doi: 10.1016 / j.pupt.2013.03.009. Epub 2013 Mar 21.

Work that in addition to demonstrating the clinical efficacy of the combined therapy between Sulbutamol and Ipratropium bromide, also highlights its good tolerability, denouncing the appearance of hypokalemia only in 3 patients out of 41 treated.

TOLERANCE DEVELOPMENT AT SALBUTAMOLO

Ann Allergy Asthma Immunol. 2012 Dec; 109 (6): 454-7. doi: 10.1016 / j.anai.2012.08.003. Epub 2012 Aug 22.

Work that defines the appearance of tolerance to the bronchoprotective effect with B2 agonists, describing the appearance of negative effects on this activity after regular use of Salbutamol for about 7 doses twice a day. For this reason it is important to strictly follow the medical indications.

Method of use and dosage

NAOS ®

Solution to be nebulized and for oral use with 1, 875 mg of Salbutamol and 0.375 mg of Ipratropio Bromide for single-dose container.

The definition of the therapeutic scheme is up to the doctor, after having carefully evaluated the patient's state of health and the severity of his clinical picture.

The same doctor will have to define the modalities of the employment (oral or aerosol) according to the characteristics of the patient, and thus decide the relative dosages.

Warnings NAOS ® - Salbutamol + Ipratropium bromide

Considering the mechanisms of action of the two drugs and the potential side effects, it would be advisable that the doctor, in addition to defining the therapeutic scheme, periodically supervise the therapy, evaluating the patient's health conditions.

NAOS ® should be used with the utmost caution in patients suffering from cardiovascular diseases, glaucoma, hyperthyroidism, pheochromocytoma, diabetes and prostatic hypertrophy.

The patient should also be carefully informed of the potential side effects of this therapy, so that he can recognize them promptly and consult his doctor.

NAOS ® is prohibited in and out of the race.

It is recommended to keep the medicine out of the reach of children.

PREGNANCY AND BREASTFEEDING

Given the biological mechanism of the active ingredients contained in NAOS ® and given the absence of studies able to fully clarify the safety profile of this drug for fetal health, it is necessary to extend the contraindications to use also for pregnancy and the following breastfeeding period.

Interactions

Patients receiving NAOS ® should avoid the simultaneous intake of non-selective Beta 2 agonist and beta blockers, as well as diuretics, steroids and xanthine derivatives, potentially responsible for hypokalemia.

Contraindications NAOS ® - Salbutamol + Ipratropium bromide

The use of NAOS ® is contraindicated in patients with hypersensitivity to the active substance or to one of its excipients, in patients suffering from severe heart disease, glaucoma, prostatic hypertrophy and urinary retention or intestinal obstruction syndrome.

Undesirable effects - Side effects

The use of NAOS ® could lead to headaches, coughs, dry mouth, restlessness, tachycardia, dizziness and nausea.

Fortunately, the incidence of clinically more relevant side effects such as skin rash, hypersensitivity, urticaria, angioedema and cardiac manifestations is rarer.