Ultibro Brizhaler kaps for Ingal 50mkg + 110mkg No. 30 (with device for Ingal brizhaler)


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Ultibro Brizhaler caps d / ingal 50mkg + 110mkg № 30 (with device d / inhal brizhaler)

since then d / ing., caps. hard 110 mcg + 50 mcg blister, with 1 inhal., No. 6, No. 12, No. 30
since then d / ing., caps. hard 110 mcg + 50 mcg blister, c 3 inhal., No. 90 Indacaterol 110 mcg
Glycopyrronium 50 mcg


Mechanism of action. When indacaterol and glycopyrronium are used together, they are additively effective because they act on different receptors and ways to achieve relaxation of small muscles. Due to the difference in density of β2-adrenoreceptors and M3 receptors in the central airways compared to smaller airways, β2-agonists may be more effective in relaxing small airways, while the anticholinergic compound may be more effective in large airways. Thus, for optimal bronchodilation in all parts of the human lung, the combination of β2-adrenoagonist and muscarinic receptor antagonist can be effective.

Indacaterol is a long-acting β2-adrenoreceptor agonist for use once a day. The pharmacological effects of β2-adrenoreceptors, including indacaterol, are at least partially explained by the stimulation of intracellular adenylate cyclase, an enzyme that catalyzes the conversion of ATP to cyclic 3 ', 5'-adenosine monophosphate (cyclic monophosphate). Increased cAMP causes relaxation of the smooth muscles of the bronchi. In vitro studies have shown that indacaterol is more than 24 times more potent than β2 receptor agonist compared to β1 receptors and 20 times more potent than β3 receptors. This selectivity profile is similar to that of formoterol. When inhaled, indacaterol acts locally in the lungs as a bronchodilator. Indacaterol is a partial human β2-adrenoreceptor agonist with nanomolar potency. In isolated human bronchi, indacaterol has a rapid onset and a longer duration of action. Although β2 receptors are the predominant adrenergic receptors in bronchial smooth muscles, and β1 receptors are the predominant receptors in the human heart, β2-adrenergic receptors are also in the human heart, which contains 10–50% of the total number of adrenoreceptors.The exact functions of the β2-adrenoreceptors in the heart are unknown, but their presence increases the likelihood that even highly selective β2-adrenergic agonists may exhibit cardiac effects.

Glycopyrronium is a long-acting inhaled muscarinic receptor antagonist (anticholinergic) for 1 time per day in order to support bronchodilator therapy for chronic obstructive pulmonary disease (COPD). Parasympathetic nerves are the major bronchoconstrictive neural pathways in the airways, and cholinergic tone is a key component of reversible airway obstruction in COPD. Glycopyrronium acts by blocking the bronchoconstrictive effect of acetylcholine on the smooth muscle cells of the respiratory tract, thereby expanding the airways.

Glycopyrronium bromide is a high affinity muscarinic receptor antagonist. More than 4-fold selectivity for human M3 receptors compared to human M2 receptors has been demonstrated in radioligand binding studies. It has a rapid onset of action, as evidenced by the observed kinetic parameters of receptor association / dissociation and the onset of action after inhalation in clinical studies.

The duration of action may be partially associated with a stable concentration of the active substance of the drug in the lungs, manifested in a prolonged T&№189; of glycopyrronium after inhalation of glycopyrronium, unlike that after intravenous administration.

It is a pharmaceutical drug. Use only as directed by your doctor.