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Chemical Name: Bambuterol
Bambec (Bambuterol) is converted into terbutaline in the body. Terbutaline acts by stimulating beta adrenergic receptors in many parts of the body. Stimulation of beta receptors in the lungs causes relaxation of the muscles surrounding the air passages (bronchioles), allowing the airways to open.
In conditions, such as asthma, where the muscles contract and the lining swells, narrowing the airways, it is difficult for air to pass in and out of the lungs. By opening the airways, terbutaline reverses the effects of asthma and improves breathing.
Bambec is formulated as a tablet and should be taken once daily, shortly before bedtime. The dose should be individualised. Adults: The recommended starting doses are 10mg-20mg. The 10mg dose may be increased to 20mg if necessary after 1-2 weeks, depending on the clinical effect. In patients who have previously tolerated ß2-agonists well, the recommended starting dose, as well as maintenance dose, is 20mg.
Children: Until the clinical documentation has been completed, Bambec should not be used in children.
Elderly: Dose adjustment is not required in the elderly.
Significant hepatic dysfunction: Not recommended because of unpredictable conversion to terbutaline.
Moderate to severely impaired renal function (GFR < 50ml/min): It is recommended that the starting dose of Bambec should be halved in these patients.
Bambec Side Effects:
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
Side Effects include headache, shaking, usually of the hands (tremor), awareness of your heart beat (heart palpitations),Low blood potassium level (hypokalaemia), Muscle cramp, Itchy rash (urticaria).
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
As terbutaline is excreted mainly via the kidneys, the dose of Bambec should be halved in patients with moderately to severely impaired renal function (GFR 50 mL/min).
Care should be taken with patients suffering from myocardial insufficiency or thyrotoxicosis.
Due to the hyperglycaemic effects of ß2-stimulants, additional blood glucose measurements are recommended initially when Bambec therapy is commenced in diabetic patients.
Due to the positive inotropic effects of ß2-agonists these drugs should not be used in patients with hypertrophic cardiomyopathy.
ß2-agonists may be arrhythmogenic and this must be considered in the treatment of the individual patient.
Unpredictable inter-individual variation in the metabolism of bambuterol to terbutaline has been shown in subjects with liver cirrhosis. The use of an alternative ß2-agonist is recommended in patients with cirrhosis and other forms of severely impaired liver function.
Potentially serious hypokalaemia may result from ß2-agonist therapy mainly from parenteral or nebulised administration. Particular caution is advised in acute severe asthma as this effect may be augmented by hypoxia. The hypokalaemic effect may be potentiated by concomitant treatment with xanthine derivatives, cortico-steroids and/or diuretics. It is recommended that serum potassium levels are monitored in such situations.
If a previously effective dosage regimen no longer gives the same symptomatic relief, the patient should urgently seek further medical advice. Consideration should be given to the requirements for additional therapy (including increased dosages of anti-inflammatory medication). Severe exacerbations of asthma should be treated as an emergency in the usual manner.
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