Inhaled Corticosteroids

In the second part of our study, we used a single high dose of each of three commonly prescribed inhaled corticosteroids in the United Kingdom to evaluate differences between the drugs in their effects on the HPA axis. Although a number of authors have suggested that fluticasone may have less effect than budesonide on morning […]

The incorrect use of a spacer device may leave more of the activated dose within the spacer and less available for systemic absorption through the lung. An inadequately primed spacer with high static electricity, multiple actuations, and a delay between actuation and inhalation all reduce drug delivery to the lung. Washing and polishing a spacer […]

The elevated mean cortisol level for the group (652 nmol/L) reflects the inclusion of three subjects taking the combined oral contraceptive pill, which may increase levels of steroid binding proteins and therefore elevate cortisol levels. These subjects had cortisol levels of 1,470, 1,327, and 1,310 nmol/L with little variation between the values on the two […]

We believe, therefore, that the relative potency of drugs and devices that we found in normal volunteers who received single high doses of steroids is very similar to the relative potency of the same drugs and devices when inhaled steroids are given to asthmatic subjects in repeated doses. However, the absolute effects are probably different, […]

Inhaled corticosteroids in low and medium doses are safe with regard to systemic side effects; to our knowledge, there are no reported cases of clinically relevant adrenal suppression within the licensed dose range. However, when higher doses are employed to control asthma symptoms, adrenal suppression becomes a possibility. We used a model system of a […]

Statistical Analysis For each treatment, we report the percentage change from the mean of two placebo measurements with 95% confidence intervals using software (Prism 2 Software; Graph Pad Software; San Diego, CA). Wilcoxon matched pairs signed rank test was used. The percent fall in plasma cortisol level for the least suppressive treatment (budesonide via MDI […]

High doses of drugs were used to magnify the differences between them. Two milligrams of fluticasone and budesonide was used to assess the effects of doses that might be used in clinical practice and to study the dose-response relationship. Drugs were taken in random order at least 7 days apart. All subjects were instructed in […]

Subjects Sixteen healthy, nonsmoking volunteers aged 25 to 42 years completed the study (12 were men). All were steroid naive and taking no other medication. Each subject gave written informed consent, and the study was approved by the Salford Local Research Ethics Committee. Protocol This was a double-blind, crossover, placebo-controlled trial. For the first experiment, […]

A Comparison of Four Inhaler Devices and Three Drugs in Healthy Adult Volunteers Inhaled steroids are used extensively in the man agement of asthma. Sometimes high doses (> 1,500 ^g/d) are necessary to control symptoms. Systemic effects such as suppression of the hypothalamic-pituitary-adrenal (HPA) axis can occur at these high doses; however, there are few […]