";s:4:"text";s:5484:" Treatment consists of discontinuation of The judicious use of cardioselective beta-receptor blockers may be considered, bearing in mind that such medication can produce bronchospasm. If the patient needs more doses of levosalbutamol sulphate inhalation solution than usual, this may be a marker of destabilisation of asthma and requires re-evaluation of the patient and treatment regimen, giving special consideration to the possible need for anti-inflammatory treatment, e.g. In animal studies, oral administration of levosalbutamol hydrochloride to pregnant New Zealand White rabbits found no evidence of teratogenicity at doses up to 25 mg/kg/day (approximately 108 times the maximum recommended daily inhalation dose of levosalbutamol hydrochloride for adults on a mg/mA study in which pregnant rats were dosed with radiolabeled racemic albuterol sulphate demonstrated that drug-related material is transferred from the maternal circulation to the foetus.Because of the potential for beta-adrenergic agonists to interfere with uterine contractility, the use of levosalbutamol sulphate inhalation solution for the treatment of bronchospasm during labour should be restricted to those patients in whom the benefits clearly outweigh the risk. Immediate hypersensitivity reactions following the use of ipratropium bromide have been demonstrated by rare cases of urticaria, angio-oedema, rash, bronchospasm, oropharyngeal oedema and anaphylaxis. If additional adrenergic drugs are to be administered by any route, they should be used with caution to avoid deleterious cardiovascular effects.Beta-adrenergic receptor blocking agents not only block the pulmonary effect of beta-agonists such as levosalbutamol, but may also produce severe bronchospasm in asthmatic patients. The use of physostigmine is not recommended because of worsening of cardio-toxic symptoms and induction of convulsions.Ipratropium bromide is a competitive antagonist of muscarinic acetylcholine receptors. The use of DUOLIN respules can be continued as medically indicated to control recurring bouts of bronchospasm. In addition, levosalbutamol sulphate inhalation solution, like other sympathomimetic agents, can cause adverse reactions such as hypertension, angina, vertigo, central nervous system stimulation, sleeplessness, headache, and drying or irritation of the oropharynx.The most common non-respiratory adverse reactions reported in clinical trials are headache, nausea (with or without vomiting) and dryness of the mouth.Respiratory, thoracic and mediastinal disorders: Cough, local irritation.Gastrointestinal disorders: Dryness of the mouth, nausea and disturbances in gastrointestinal motility (constipation, diarrhoea and vomiting).Eye disorders: Accommodation disturbances, narrow-angle glaucoma.Respiratory, thoracic and mediastinal disorders: Spasms of larynx.Immune system disorders: Anaphylactic reactions, angio-oedema on the tongue, lips and face.Eye disorders: Increased intraocular pressure, pain in the eyes, mydriasis.Cardiac disorders: Palpitations, supraventricular tachycardia, atrial fibrillation.Respiratory, thoracic and mediastinal disorders: Bronchospasms induced by the inhalation.If case of any side effects, talk to your doctor or pharmacist or write to The expected symptoms with overdosage are those of excessive beta-adrenergic receptor stimulation and/or occurrence or exaggeration of any of the symptoms, including seizures, angina, hypertension or hypotension, tachycardia with rates up to 200 beats/minute, arrhythmias, nervousness, headache, tremor, dry mouth, palpitation, nausea, dizziness, fatigue, malaise, and sleeplessness. DUOLIN respules are for oral inhalation only. Reactions have included urticaria, angio-oedema, rash, bronchospasm, anaphylaxis, and oropharyngeal oedema. These data are presented in Table 2. The half-life of the terminal elimination phase is about 1.6 hours.The average total clearance has been estimated to be 2.3 L/min.