Abstract
Objective: Evidence-based management of bronchial asthma and wheezing in children and adults recommend the employment of inhaled corticosteroids (ICS). Difficulty in using some inhalation devices for ICS delivery such as pressurized metered-dose and dry-powder inhalers are common in young children and in the elderly, and for that reason they are replaced with nebulizers. Methods: We reviewed literature with comparative studies that evaluated funisolide with other ICS currently available on the market, including beclomethasone dipropionate, fluticasone propionate, and budesonide. Moreover, we assessed the role physico-chemical properties of these ICS in determining the drug fate in lung. Results: Data indicate that flunisolide output in respirable particles by any type of pneumatic nebulizer (traditional, open breath or breath-enhanced) is superior to other ICS. This is principally attributed to the higher water solubility of flunisolide. Furthermore, in vivo simulation studies demonstrate that the inter-subject variability of the inhaled dose by asthmatic children was much greater for suspensions of fluticasone propionate and beclomethasone dipropionate than for that of flunisolide. Conclusion: The physicochemical properties and pharmacokinetic profile of flunisolide favor its employment in nebulization.
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