Budesonide Inhalation Research Articles

Budesonide inhaler device switch patterns in an asthma population in Swedish clinical practice (ASSURE).

Dry powder inhaler (DPI) device switch in asthma treatment could potentially increase with the entrance of new devices. We examined the switch patterns of budesonide (BUD) DPI analogues available in Sweden. This observational real-life study linked primary healthcare medical records data from the Västra Götaland region to national Swedish registries, and included asthma patients (ICD-10-CM J45) prescribed BUD in a multidose DPI. Index date: first dispense of BUD DPI. Switch date: prescription of another BUD DPI device. Study outcomes (switch vs. non-switch) were exacerbations and prescription of short-acting β2 -agonists. Study period was 1 July 2005 to 31 October 2013. Overall, 15,169 asthma patients were on treatment with BUD DPI; 1178 (7.35%) switched to another BUD DPI during the study. Pair-wise 1:1 matching of switchers vs. non-switchers resulted in two groups of 463 patients each (mean age 36 years, 55% female patients). A 25% higher exacerbation rate was seen postswitch (0.40 vs. 0.32; p = 0.047). Switchers were 4.5 year younger and had lower medication possession rate than non-switchers. Switch without primary healthcare visit did not differ between groups regarding consultations and exacerbations (no visit 4.96 and 0.90; visit 4.29 and 0.77, respectively). However, patients without primary healthcare visit at switch had significantly more outpatient hospital visits (2.01 vs. 0.81; p < 0.001). Considering the low switch rate, asthma patients and physicians in Swedish general practice seem reluctant to switch to another BUD DPI device. Switch, especially without primary healthcare visit, was associated with decreased asthma control resulting in higher exacerbation rate and more outpatient hospital visits.

Effect of nebulized corticosteroids on long-term poorly controlled asthma in elderly patients

Objective To evaluate the efficacy and safety of long-term nebulized corticosteroids and inhaled bronchodilators therapy on asthma in long-term poor controlled elderly patients. Methods Prospective, randomized control study was conducted. 63 elderly asthma patients, who received inhaled corticosteroids or combined with other long-term medication treatment for asthma control for more than 3 months but were still in moderate to severe persistent asthma state, were randomly divided into nebulizer treatment group (n=31) and dry powder inhalation group (n=32), and they were treated correspondingly with Budesonide inhalation suspension 1 mg and Salbutamol 2.5 mg BidorBudesonide/Formoterol powder 320/9 μg inhalation Bid. Patients in the two groups were evaluated for the differences in lung function, acute exacerbations of asthma, asthma control test (ACT) and adverse effects after 12-week treatment. Results The improvement in morning peak expiratory flow (PEF) and ACT score were better in the test group than in the control group 〔(29.2±14.4) ml vs. (15.8±13.5) ml, (4.8±2.2) vs. (3.0±2.7), t=3.715 and 2.897, P=0.000 and 0.005〕, but there were no statistical differences in average daily use of relievers and severe acute exacerbations between the test and control groups (t=-1.512, P=0.136; χ2=2.238, P=0.135). The local adverse effects caused by inhaled corticosteroids had no significant difference between the two groups. Conclusions Compared with the powder inhalation, the nebulizer inhalation administration of corticosteroids and bronchodilators could improve the asthma symptoms and lung function better in elderly patients with serious asthma condition and shows a good safety in the 12 weeks of continuous treatment. Key words: Asthma; Glucorticosteroids; Metered dose inhalers

Effects of Laminaria japonica polysaccharides on airway inflammation of lungs in an asthma mouse model.

BackgroundAsthma is a serious chronic inflammatory disease affecting 300 million people worldwide. This aim of this study to investigate the anti-inflammatory and anti-asthmatic effects of Laminaria japonica extract in the ovalbumin (OVA)-induced mouse asthma model.MethodsA mouse asthma model was established in SPF Kunming mice by OVA-sensitization followed by inhalation of aerosol allergen for two weeks. Laminaria japonica polysaccharides (LJPS) were given by gavage feeding at 50 mg/kg/day during OVA inhalation challenge period, and their effect on asthma was compared with the standard treatment of Budesonide inhalation. The total inflammatory cells and eosinophils in bronchoalveolar lavage fluid (BALF) were determined. Histopathological changes in lung tissue were studied and scored to determine the degree of inflammation. Levels of IL-12, IL-13, and TGF-β1 in BALF as well as serum levels of IgE were measured. Expressions of IL-12, IL-13, and TGF-β1 in lung tissues were assessed.ResultsHighly inflammatory lungs infiltrated with significant increased eosinophils were observed in OVA-induced asthmatic mice. The OVA treated mice presented with a lower level of IL-12 and higher levels of IL-13 and TGF-β1 in BALF and lung tissues, as well as an increased level of the serum IgE. Treatment with LJPS (Group B) significantly decreased the numbers of eosinophils in the BALF (P < 0.05) and alleviated lung inflammation compared to the untreated asthma mice (Group A). It also reduced the serum IgE levels, increased expression of IL-12, and decreased the expression of IL-13 and TGF-β1 in BALF and lung (Both P < 0.05) compared with the group A.ConclusionsLJPS can significantly inhibit airway inflammation of asthmatic mice, adjust the balance of cytokines, and improve the pulmonary histopathological condition. Our data suggested that LJPS might be a potential therapeutic reagent for allergic asthma.

Effects of Laminaria japonica polysaccharides on airway inflammation of lungs in an asthma mouse model

Background: Asthma is a serious chronic inflammatory disease affecting 300 million people worldwide. This aim of this study to investigate the anti-inflammatory and anti-asthmatic effects of Laminaria japonica extract in the ovalbumin (OVA)-induced mouse asthma model.&#x0D; Methods: A mouse asthma model was established in SPF Kunming mice by OVA-sensitization followed by inhalation of aerosol allergen for two weeks. Laminaria japonica polysaccharides (LJPS) were given by gavage feeding at 50 mg/kg/day during OVA inhalation challenge period, and their effect on asthma was compared with the standard treatment of Budesonide inhalation. The total inflammatory cells and eosinophils in bronchoalveolar lavage fluid (BALF) were determined. Histopathological changes in lung tissue were studied and scored to determine the degree of inflammation. Levels of IL-12, IL-13, and TGF-β1 in BALF as well as serum levels of IgE were measured. Expressions of IL-12, IL-13, and TGF-β1 in lung tissues were assessed.&#x0D; Results: Highly inflammatory lungs infiltrated with significant increased eosinophils were observed in OVAinduced asthmatic mice. The OVA treated mice presented with a lower level of IL-12 and higher levels of IL-13 and TGF-β1 in BALF and lung tissues, as well as an increased level of the serum IgE. Treatment with LJPS (Group B) significantly decreased the numbers of eosinophils in the BALF (P&lt;0.05) and alleviated lung inflammation compared to the untreated asthma mice (Group A). It also reduced the serum IgE levels, increased expression of IL-12, and decreased the expression of IL-13 and TGF-β1 in BALF and lung (Both P &lt; 0.05) compared with the group A.&#x0D; Conclusions: LJPS can significantly inhibit airway inflammation of asthmatic mice, adjust the balance of cytokines, and improve the pulmonary histopathological condition. Our data suggested that LJPS might be a potential therapeutic reagent for allergic asthma.

Observation of the effect and the influence on PCT,CRP in the treatment of patients with acute exacerbation pulmonary disease by Budesonide and ipratropium bromide

Objective To observe the effect and the influence on PCT,CRP in the treatment of patients with acute exacerbation pulmonary disease by Budesonide and ipratropium bromide. Methods 80 patients with acute exacerbation pulmonary disease were randomly divided into 40 cases of the control group and 40 cases of the observation group, the two groups were given routine treatment, the control group then had been given ipratropium bromide for 7d, and the observation group had been given Budesonide and ipratropium bromide for 7d,the blood gas indicators (PaO2,PCO2), pulmonary function(FEV1,PEF,FEV1/FVC),dyspnoea and exercise tolerance score, serum PCT levels, serum CRP levels and clinical efficacy were compared, Adverse reactions were recorded. Results (1)the PaO2, FEV1,PEF,FEV1/FVC of the observation group and the control group after treatment were(70.7±2.3)mm Hg and (62.5±3.0)mm Hg,(2.15±0.63)L and(1.76±0.56)L,(3.49±0.82)L/s and(3.06±0.75)L/s,(68.52±6.53)% and(60.14±6.03)%, These indicators were significantly higher than those before treatment,all P<0.05,the PCO2, PCT,CRP were(51.4±1.7)mm Hg and(56.6±2.3)mm Hg,(1.75±1.20)μg/L and(2.58±1.17)μg/L,(10.25±6.77)mg/L and(19.07±5.75)mg/L,These indicators were significantly lower than those before treatment,all P< 0.05,the PaO2,FEV 1,PEF,FEV 1/FVC of the observation group were significantly higher than those of the control group,the PCO 2,PCT,CRP were significantly lower than those of the control group, all P<0.05;(2)The dyspnoea and exercise tolerance score of the observation group and the control group after treatment was significantly lower than those before treatment, the dyspnoea and exercise tolerance score of the observation group was significantly lower than those of the control group;(3)The clinical total effective rate of the observation group was 90%,which was higher than 65%of the control group(χ2=7.312,P<0.05). Conclusion The method containing Budesonide and ipratropium bromide Inhalation has exact effect, and can effectively improve respiratory function, which is an effective treatment of choice for acute exacerbation of COPD. Key words: Pulmonary disease, chronic obstructive; Budesonide; Compound ipratropium bromide; Procalcitonin; C-reactive protein

Budesonide inhalation ameliorates endotoxin-induced lung injury in rabbits.

Acute respiratory distress syndrome (ARDS) is a serious clinical problem that has a 30-50% mortality rate. Budesonide has been used to reduce lung injury. This study aims to investigate the effects of nebulized budesonide on endotoxin-induced ARDS in a rabbit model. Twenty-four rabbits were randomized into three groups. Rabbits in the control and budesonide groups were injected with endotoxin. Thereafter, budesonide or saline was instilled, ventilated for four hours, and recovered spontaneous respiratory. Peak pressure, compliance, and PaO2/FiO2 were monitored for 4 h. After seven days, PaO2/FiO2 ratios were measured. Wet-to-dry weight ratios, total protein, neutrophil elastase, white blood cells, and percentage of neutrophils in BALF were evaluated. TNF-α, IL-1β, IL-8, and IL-10 in BALF were detected. Lung histopathologic injury and seven-day survival rate of the three groups were recorded. Peak pressure was downregulated, but compliance and PaO2/FiO2 were upregulated by budesonide. PaO2/FiO2 ratios significantly increased due to budesonide. Wet-to-dry weight ratios, total protein, neutrophil elastase, white blood cells and percentage of neutrophils in BALF decreased in the budesonide group. TNF-α, IL-1β, and IL-8 levels decreased in BALF, while IL-10 levels increased in the budesonide group. Lung injuries were reduced and survival rate was upregulated by budesonide. Budesonide effectively ameliorated respiratory function, attenuated endotoxin-induced lung injury, and improved the seven-day survival rate.

Budesonide inhalation suspension versus methylprednisolone for treatment of moderate bronchial asthma attacks

Background Owing to their side effects, administration of steroids for bronchial asthma attacks should be minimized. We investigated whether budesonide inhalation suspension (BIS) could replace intravenous steroid administration for the treatment of moderate bronchial asthma attacks.Subjects and Methods The subjects were children aged 5 years and younger hospitalized for moderate bronchial asthma attacks. Patients were randomly assigned to one of two groups: 20 patients received methylprednisolone (mPSL) and 20 were treated with BIS. The mPSL group began treatment with inhalation of procaterol hydrochloride (0.3 mL) and disodium cromoglycate (2 mL) three times a day and systemic administration of mPSL (1 mg/kg) three times a day. The BIS group began treatment with inhalation of procaterol hydrochloride (0.3 mL) and BIS (0.5 mg) three times a day. The frequency of inhalations and steroid administration was adjusted according to the severity of symptoms. The cortisol level at discharge was measured.Results There were no significant differences between the two groups in terms of the severity of attacks and duration of management, or in terms of therapeutic efficacy, duration of wheezing, or period of hospitalization. The frequency of inhalations on days 3 to 6 of hospitalization was lower in the BIS group than in the mPSL group, and the cortisol level at discharge was significantly higher in the BIS group (13.9 ± 6.1 μg/dL) than in the mPSL group (8.0 ± 2.1 μg/dL) (p = 0.008).Conclusion In patients with recurrent wheezing or bronchial asthma of <5 years, the efficacy of BIS is equivalent or better than mPSL for moderate bronchial asthma attacks, and in contrast to steroid treatment, BIS treatment do not suppress adrenocortical function.

Clinical equivalence of budesonide dry powder inhaler and pressurized metered dose inhaler

A delivery device is the most important factor that determines the local/systemic bioavailability of inhaled corticosteroids. Dry powder inhalers (DPIs) and pressurized metered dose inhalers (pMDIs) are the most commonly used delivery devices for localized drug delivery to the airways. This study was to compare the clinical equivalence of budesonide delivered by the Pulmicort Turbuhaler (DPI) and the Aeronide inhaler (pMDI). The two inhalers were compared for their pharmaceutical equivalence and clinical equivalence. The in vitro test included the uniformity of the delivered dose and determination of the aerodynamic particle size of budesonide. The in vivo test was carried out in 36 patients with mild to moderate asthma. This was a randomized, single-blinded study conducted for a period of 3 months. This included assessment of the spirometric parameters [forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR), forced expiratory flow 25-75% (FEF25-75)], the severity of asthma symptoms, adverse events, frequency of short-acting inhaled bronchodilator usage and measurement of urinary cortisol levels. The aerodynamic particle size was slightly different between the two inhalers (2.3 ± 0.2 µm for Pulmicort Turbuhaler and 2.2 ± 0.2 µm for Aeronide inhaler). Both inhalers passed the uniformity of delivered dose (95.4% and 97.4%) specified in the British Pharmacopoeia. There was no statistically significant difference observed between the two inhalers in terms of the spirometric parameters, symptom-free days, frequency of bronchodilator usage and the level of urinary cortisol. In addition to pharmaceutical equivalence, no clinical difference observed between the two budesonide inhalers.

A 26-Year-Old Man With a Slowly Growing Heterogeneous Intrathoracic Mass

A 26-year-old man presented with complaints of left-sided chest pain and shortness of breath with moderate exertion, of 6 month duration. The patient had a history of asthma but reported that the exertional shortness of breath was not like his typical asthma symptoms and was not associated with wheezing. The left-sided chest pain was a dull and constant ache, without any aggravating or relieving factors. The patient denied fever, chills, night sweats, cough, or weight loss. Past medical history was significant for asthma since childhood, which was well controlled on budesonide inhaler. He had received a gunshot wound 1½ years earlier and had abdominal surgery at that time “to stop the bleeding,” but records of the procedure were not accessible.

Immediate antiinflammatory effects of inhaled budesonide in patients with asthma.

In patients with asthma, single doses of inhaled glucocorticosteroids (ICS) have been reported to have antiinflammatory actions that can be detected several hours after drug administration. However, the onset and duration of the effect have not been investigated. We therefore measured airway blood flow ([Formula: see text]aw) as an index of airway inflammation to determine the time course and dose dependence of the antiinflammatory action of an ICS in 20 patients with moderate asthma receiving regular ICS treatment. [Formula: see text]aw and spirometry were measured before and serially for 360 minutes after a single inhaled dose of 360 μg, 720 μg, and 1,440 μg budesonide or placebo as well as after four repetitive 720-μg budesonide doses given 30 minutes apart. Baseline mean [Formula: see text]aw was increased and FEV1 was decreased without significant differences among the 5 treatment days. After budesonide inhalation, there was a transient, dose-dependent decrease in mean [Formula: see text]aw from 12 to 21%, with significant differences from baseline at 60 and 90 minutes for the 720-μg and 1,440-μg doses (P < 0.05). Thirty minutes after four repetitive budesonide administrations, mean [Formula: see text]aw was 28% below baseline (P < 0.05) and remained 11% below baseline after 270 minutes. There was no change in mean FEV1 after any of the treatments. In subjects with moderate asthma who use ICS regularly, inhaled budesonide caused a transient dose-dependent vasoconstriction in the airway, thereby reversing one manifestation of airway inflammation. These results suggest that a pure controller medication can have immediate beneficial effects not paralleled by changes in airflow. Clinical trial registered with www.clinicaltrials.gov (NCT 01219738).

Budesonide inhalation in the treatment of pneumoconiosis disease curative effect observation

目的 观察布地奈德粉吸入治疗尘肺病的效果.方法 将尘肺患者76例随机分成2组,对照组38例,常规给予抗纤维化、止咳、化痰等治疗;观察组38例,在常规治疗的基础上,予布地奈德吸入200 μg,2次/d,连续用药6个月.观察治疗前后的临床症状和肺功能变化,进行疗效判定.结果 对照组总有效率65.79％,观察组总有效率94.74％,两组比较,差异有统计学意义(P＜0.05).治疗后观察组用力肺活量(FVC)、第1秒用力呼气容积(FEV10)及FEV1.0/FVC均明显高于对照组,差异均有统计学意义(P＜0.05).结论 布地奈德吸入治疗尘肺病对改善症状及同期肺功能有肯定疗效。

Prophylactic effectiveness of budesonide inhalation in reducing postoperative throat complaints

Postoperative sore throat (POST) is one of the main postoperative complaints. This study was to evaluate the efficacy of budesonide inhalation suspension (BIS) in reducing the incidence and severity of POST. One hundred and twenty patients scheduled for thyroid surgery with general anesthesia were enrolled and randomized into three groups. Group A received 200mcg BIS 10min prior to the tracheal intubation and received the same treatment 6 and 24h after extubation. Group B received 200mcg BIS 6 and 24h after extubation. Control group received the same scheduled treatment as Group A, but the BIS was replaced with 2ml normal saline. The patients were evaluated for sore throat and hoarseness 1, 24 and 48h after extubation. The status of laryngopharynx was also recorded. There was no statistically significant difference in the incidence of sore throat among three groups. However, hoarseness occurred significantly less frequently in Group A (P<0.05). Onehour after extubation, Group A exhibited significantly less severe sore throat and hoarseness compared to the other two groups (P<0.05), which disappeared 24h later. The mucositis scores of laryngopharynx at 1, 24 and 48h post-extubation were significantly lower in Group A (P<0.05). BIS can reduce the incidence and severity of the POST prophylactically.

盐酸氨溴索联合布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期的护理体会

盐酸氨溴索联合布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期的护理体会

Combination of budesonide/formoterol on demand improves asthma control by reducing exercise-induced bronchoconstriction

BackgroundIn mild asthma exercise-induced bronchoconstriction (EIB) is usually treated with inhaled short-acting β2 agonists (SABAs) on demand.ObjectiveThe hypothesis was that a combination of budesonide and formoterol on demand diminishes EIB...

Bronchiolitis Obliterans Associated with Stevens-Johnson Syndrome and Response to Azathioprine

To the Editor: Stevens-Johnson syndrome (SJS) is an acute, self-limiting, immune-complex mediated hypersensitivity disorder of skin and mucus membranes. Though acute pulmonary complications are well described, persistent pulmonary sequelae associated with SJS are rare [1]. We describe severe progressive form of bronchiolitis obliterans (BO) following SJS and good response to azathioprine. A 9-y-old boy developed SJS following oral ibuprofen prescribed for febrile illness. A week later, he developed persistent cough, wheezing and progressive respiratory distress. At admission, he had tachypnea, retractions, extensive wheezing and crepitations with hyperpigmented scars, cicatrical ectropion in the left eye and dystrophic changes in nails. Oxygen-saturation was 87 % in room-air. Pulmonary function test showed severe obstruction with no response to bronchodilators. Chest-radiograph and high-resolution computerized tomography were consistent with BO (Figs. 1 and 2). He received supplemental oxygen, β2-agonist and budesonide inhalations, chest-physiotherapy and prednisolone. Azithromycin three times a week was also added. At 2-mo follow-up, he had persistent cough, exertional dyspnea and wheeze for which azathioprine was added as a steroid sparing agent. At 1-year follow-up, the patient improved clinically and was able to do his daily activities at home. Oxygenation and PFT improved. Although, he had dyspnea on moderate exertion, intermittent cough with wheeze, the symptoms had not worsened and the disease appeared to be controlled. BO may occur within days after SJS even when the initial pulmonary involvement is not severe [1]. The association of non-steroidal anti-inflammatory drugs like ibuprofen with SJS is well known [2]. The findings of mosaic perfusion, vascular attenuation and central bronchiectasis onHRCTare diagnostic of BO obviating the need for lung-biopsy in a consistent clinical setting, as in index case [3]. The anti-inflammatory effects of corticosteroids justify their use in the early phases. We added immune-modulator azathioprine which suppresses lymphocyte proliferation and decreases CD8+ lymphocyte subpopulation, as a corticosteroid sparing agent for control of inflammation. Previous anaecdotal reports in adults have suggested that azathioprine might be useful as a corticosteroidsparing agent for the treatment of organizing pneumonia [4]. Moreover, drugs like mycophenolate mofetil and azathioprine have also been used for prevention of bronchiolitis obliterans

Nebulized budesonide inhalation combined with cimetidine for bronchial asthma in children

Objective To observe the clinical efficacy of nebulized budesonide inhalation combined with cimetidine in the treatment of bronchial asthma in children.Methods 135 children with bronchial asthma were randomly divided into a study group （67 patients） and a control group （68 patients） according to the random number table.The control group received nebulized budesonide inhalation therapy in addition to conventional treatment; while the study group received intravenous infusion of cimetidine of 15 mg/kg once daily in addition to the therapies used in the control group.The treatment course was 7 days for both groups.Results The time to symptom disappearance and length of hospital stay were significantly shorter in the study group than in the control group （P〈0.05）.The total effectiveness rate was was significantly higher in the study group than in the control group （94.03% vs.76.47%,P〈0.05）.The incidence rate of gastrointestinal symptoms,as compared with the control group,was significantly reduced in the study group （P〈0.05）.Conclusions Nebulized budesonide combined with cimetidine is safe and effective in the treatment of bronchial asthma in children,and it is worth using for clinical reference. Key words: Nebulized budesonide; Cimetidine; Children; Bronchopneumonia

Effect of exterior point application combined with herbal concentrate-granules on 60 cases of asthma

Objective To observe the effect of combined therapy of external point application and herbal concentrate-granules on patients with asthma (hot wheezing in TCM).Methods 60 patients suffering from onset period of bronchial asthma were randomized to a control group and a treatment group.The control group was given budesonide inhaler and theophylline sustained release tablets.The treatment group was given combined therapy of external point application and herbal concentrate-granules.The course of treatment was 10 days.To observe the value ofFEV1％,ACT scores and TCM syndrome scores etc.Results After treatment,the value of FEV 1％ [treatment group:(82.83 ± 11.35) ％,control group:(83.85 ± 16.72) ％] and ACT [treatment group:(19.86±2.32),control group:(19.66±2.54)] in both groups were markedly increased with statistical significance (P＜0.01); and the difference between the two groups were also significant; TCM syndrome scoring [treatment group:(4.27±3.65),control group:(5.05±4.14)] was notably decreased in both groups compared with the values before the treatment with statistical significance (P＜0.01); but the difference between the two groups was not significant (P＞0.05).Conclusion The combined therapy of external point application and herbal concentrate-granules can treat bronchial asthma in the acute clinical course and improve lung function. Key words: Exterior and interior combined therapy; Hot wheezing; Asthma

Contrast study between budesonide inhalation with methylperdnisolone intravenous in the treatment of acute exacerbation of chronic obstructive pulmonary disease

Objective To compare the effect and safety between budesonide inhalation with methylperdnisolone intravenous in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 80 patients with AECOPD were divided into the control group and observation group randomly,each group 40 cases.Based on regular treatment,the patients in the control group received intravenous treatment of methylprednisolone,while patients in the observation group receive inhaled treatment of budesonide.The near-term and long-term effect,symptom score,and the indicators such as FEV1/FVC,MMEF,PaO2,PaCO2 and AHR were observed and compared beween the two groups before and after treatment.Results Compared with control group,there were no significant differences of short-term and long term treatment effects and symptom score in observation group(all P ＞ 0.05) ;The indicators of pulmonary function and blood gas analysis improved significantly in all patients after treatments(all P ＜ 0.05),but there were no significant differences between two groups(all P ＞0.05) ;The incidence of side effects in observation group was significantly lower than that of control group (P ＜ 0.05).Conclusion Glucocorticoid in the treatment of AECOPD has clear effect,and regardless of the mode of administration,it has good near-term and longterm effect.But in adverse reactions budesonide inhalation is significantly superior to methylprednisolone intravenous therapy. Key words: Pulmonary disease, chronic obstructive; Budesonide ; Methylprednisolone

Aerosol Characteristics of Admixture of Budesonide Inhalation Suspension with a Beta2-Agonist, Procaterol

Nebulized drugs for asthma treatment are often mixed together in order to simplify inhalation regimens, although not recommended. We therefore evaluated aerosol characteristics and physicochemical stability of the admixture of an inhaled corticosteroid suspension with a beta2-agonist solution. An 8-stage cascade impactor was used to measure the particle size distribution of admixture of Pulmicort® Respules® (budesonide, 0.5mg/2mL) with Meptin® Inhalation Solution Unit (procaterol hydrochloride, 30μg/0.3mL) from a jet nebulizer, PARI LC Plus®. Concentration of each drug was assayed with high-pressure liquid chromatography. Physicochemical compatibility was also assessed up to 24 hours after mixing. With regard to budesonide, impactor parameters such as mass median aerodynamic diameter (MMAD) and respirable mass (RM) were comparable between admixtures and single-drug preparations (2.92 ± 0.03 vs 2.99 ± 0.14μm, 146.8 ± 2.9 vs 147.6 ± 8.2μg, respectively). On the other hand, delivery rates of procaterol increased when admixed with budesonide suspension, resulting in significantly higher RM (15.1 ± 0.8 vs 10.2 ± 0.5μg, p < 0.01). Variations from initial concentration in the percentages of drug remaining at any time point were less than 10%, and there were no appreciable changes in pH of the admixtures for up to 24 hours. There is a possibility that admixture might influence of aerodynamic characteristics of procaterol, but not budesonide. In vivo data will be needed for the clinical implications of our findings.

Comparative study of fluticasone propionate with budesonide and beclomethasone dipropionate in mild persistent bronchial asthma

Objective: To compare the efficacy and adverse effects of fluticasone propionate with that of budesonide and beclomethasone dipropionate in mild persistent cases of bronchial asthma. Methods: This was an open label, randomized parallel group study done in Government General and Chest Hospital, Hyderabad for a period of 12 weeks. Each group had 20 patients. The group I was given fluticasone propionate inhalation therapy 100μg twice daily. Group II was given budesonide inhalation therapy 200μg twice daily. Group III was given beclomethasone dipropionate inhalation therapy 200μg twice daily. Results: Symptomatic improvement was observed in all three groups. At end point, mean FEV1 in fluticasone propionate treatment group improved by 22.04% compared with 14.53% in budesonide and 12.02% in beclomethasone treatment groups. At end point, mean FVC value of the fluticasone propionate treatment group improved by 8.04% compared with 5.29% in budesonide and 4.27% in beclomethasone groups. Mean FEV1 / FVC also improved by 12.76% in the fluticasone propionate group compared with 8.63 % in budesonide and 7.45 % in beclomethasone groups. No adverse effects were reported in any of the treatment groups. Conclusion: This study showed that fluticasone propionate is superior to budesonide and beclomethasone in improving lung function, decreasing symptoms and need for rescue medication in mild persistent asthma