Corticosteroid budesonide

Rhinocort Aqua and Nasonex are preparations containing topical nasal corticosteroids (budesonide and mometasone furoate respectively). Otrivine contains a nasal decongestant (xylometazoline) and Sudafed is a systemic preparation containing a nasal decongestant (phenylephrine). Molcer is a preparation for ear-wax removal and which contains docusate sodium. Emadine contains an antihistamine (emedastine) and is presented as eye drops. 

Rhinocort Aqua is the proprietary preparation of a topical nasal spray containing the corticosteroid budesonide and is marketed by AstraZeneca. 

Van Hecke EV, Temmerman L (1980) Contact allergy to the corticosteroid budesonide. Contact Dermatitis 6 509... 

Certain diseases of the digestive tract may be best treated by delivery of the therapeutic active agent directiy to the affected areas instead of indirectly through the systemic circulation. In instances where the active agent is poorly water-soluble, it may be highly desirable to administer the agent in fine particle form (nanoparticles or microparticles). One such commercial product is Entocort EC, a capsule containing the anti-inflammatory corticosteroid budesonide in micronized form. Entocort EC (Prometheus Laboratories, Inc.) is indicated for the treatment of mild to moderate Crohn s disease. 

Laitinen LA, Laitinen A, Haahtela T. A comparative study of the effects of an inhaled corticosteroid, budesonide, and a Pj-agonist, terbutaline, on airway inflammation in newly diagnosed asthma a randomized, double-blind, parallel-group controlled trial. J Allergy Clin Immunol 1992 90 32-42. 

Inhaled steroids (commonly used are beclomethasone, budesonide, triamcinolone, fluticasone, flunisolide) appear to attenuate the inflammatory response, to reduce bronchial hyperreactivity, to decrease exacerbations and to improve health status they may also reduce the risk of myocar dial infar ction, but they do not modify the longterm decline in lung function. Whether- steroids affect mortality remains unclear. Many patients appear to be resistant to steroids and large, long-term trials have shown only limited effectiveness of inhaled corticosteroid ther apy. Certainly, the benefit from steroids is smaller in COPD than in asthma. Topical side-effects of inhaled steroids are oropharyngeal candidiasis and hoarse voice. At the normal doses systemic side-effects of inhaled steroids have not been firmly established. The current recommendation is that the addition of inhaled gluco-coiticosteroids to bronchodilator treatment is appropriate for patients with severe to veiy sever e COPD. 

Because budesonide has the most safety data in humans, it is the preferred inhaled corticosteroid and is the only inhaled corticosteroid classified as pregnancy category B however, there are no data indicating that other inhaled corticosteroids contribute to increased risk to the mother or fetus.43 Because... 

Budesonide 9 mg orally once daily for up to 8 weeks may be used for mild to moderate active CD in patients with involvement of the terminal ileum or ascending colon, with success expected in 50% to 60% of patients.23 Because the formulation releases budesonide in the terminal ileum, it is not effective in reaching sites distal to the ascending colon.23,36 Conventional oral corticosteroids such as prednisone and methylprednisolone may be used for patients who are unresponsive to aminosalicylates or budesonide. 

Patients with moderate to severe active CD may be treated with oral corticosteroids, such as prednisone 40 to 60 mg daily.2 Budesonide 9 mg orally once daily may be used for moderate active CD involving the terminal ileum or ascending colon. Infliximab is an effective alternative to corticosteroid therapy for patients with moderate to severe CD, including patients with fistulizing or perianal disease.15,37-39 The recommended regimen for induction of remission is infliximab 5 mg/kg at weeks 0, 2, and 6 it is effective in inducing remission in... 

Budesonide (Rhinocort) 32 meg spray, 1-4 sprays in each nostril daily Preferred corticosteroid for allergic rhinitis. 

Currently, six intranasal corticosteroids—beclomethasone, budesonide, flunisolide, fluticasone, mometasone, and triamcinolone—are available commercially. Although all... 

Intranasal corticosteroids are the most effective anti-inflammatory agents used in pediatric patients with allergic rhinitis. Although fewer studies have been conducted in children, results demonstrate that intranasal corticosteroids are effective and well tolerated, with an adverse-effect profile similar to placebo. Mometasone is indicated for children as young as 2 years of age, fluticasone is indicated for children 4 years of age and older, and beclomethasone, budesonide, flunisolide, and triamcinolone are indicated for children 6 years and older.15 Because concerns regarding effect of intranasal steroids on growth exist, the growth of pediatric patients prescribed intranasal steroids should be monitored routinely via stadiometry. 

Corticosteroids and adrenocorticotropic hormone have been widely used for the treatment of ulcerative colitis and Crohn s disease and are used in moderate to severe disease. Prednisone is most commonly used. Budesonide is an oral controlled-release formulation that minimizes systemic effects. 

Low-dose inhaled corticosteroids are the treatment of choice for women with mild persistent asthma. Budesonide is preferred, but other inhaled corticosteroids that were used effectively prior to pregnancy can be continued. 

Intranasal corticosteroids are the most effective treatment for allergic rhinitis during pregnancy. Beclomethasone and budesonide have been used most. Nasal cromolyn and first-generation antihistamines (chlorpheniramine, tripelennamine, and hydroxyzine) are also considered first-line therapy. Loratadine and cetirizine have not been as extensively studied. 

Several studies have shown an additive effect with the combination of inhaled corticosteroids and long-acting bronchodilators. Combination therapy with salmeterol plus fluticasone or formoterol plus budesonide is associated with greater improvements in FEVj, health status, and exacerbation frequency than either agent alone. The availability of combination inhalers makes administration of both drugs convenient and decreases the total number of inhalations needed daily. 

U. B. Kompella, N. Bandi, and S. P. Ayalasomayajula. Subconjunctival nano- and microparticles sustain retinal delivery of budesonide, a corticosteroid capable of inhibiting VEGF expression. Invest Ophthalmol Vis Sci 44 1192-1201 (2003)... 

Both budesonide and fluticasone are corticosteroids but fluticasone is more potent than budesonide and has a higher first-pass effect, hence more of the drug is metabolised leading to fewer adverse effects. A dose of 100 pg of budesonide is equivalent to 50 pg of fluticasone. Both budesonide and fluticasone are indicated for the prophylaxis of allergic rhinitis (hay fever). 

Asthma is managed by the use of an inhaled bronchodilator prescribed on an as-required (p.r.n.) basis to relieve acute attacks and administration of an inhaled corticosteroid as maintenance therapy. Budesonide is available as inhaled corticosteroid. Amoxicillin or another antibacterial agent may be required for short-term periods. Codeine, being an antitussive, should be used with caution in asthmatics and certainly not routinely. 

The majority of the marketed products are used for asthma and COPD. Typical agents that are used for these indications are fl2-agonists such as salbutamol (albuterol), Terbutalin or formoterol, corticosteroids such as budesonide, FUxotide or beclomethasone and mast-cell stabilizers such as sodium cromoglycate or nedocromil. 

Asthma, chronic Maintenance and prophylactic treatment of asthma includes patients who require systemic corticosteroids and those who may benefit from systemic dose reduction/elimination for the maintenance treatment of asthma and as prophylactic therapy in children 12 months to 8 years of age (budesonide respules). 

Metabolites (Activity) beclomethasone 17-mono-propionate (active), free beclome-thasone (very weak anti-inflammatory effects) 16 -hydroxy-prednisolone and 6 -hydroxy-budesonide (< 1 % of parent) 67-OH (low corticosteroid potency) ... 

Budesonide, Oral (Entocort EC) [Anti-inflammatory> Corticosteroid] Uses Mild-mod Crohn Dz Action Steroid, anti-inflammatory Dose Adults. Initial, 9 mg PO qAM to 8 wk max maint 6 mg PO qAM taper by 3 mo avoid grapefruit juice Contra Active TB and fungal Infxn Caution [C, /-] DM, glaucoma, cataracts, HTN, CHF Disp Caps SE HA, cough, hoarseness, Candida Infxn, epistaxis Interactions T Effects W/ erythromycin, indinavir, itraconazole, ketoconazole, ritonavir, grapefruit EMS Monitor ECG and BP for signs of electrolyte disturbances and hypovolemia OD Acute OD unlikely to cause a problem, chronic OD can reduce natural production of certain steroids symptomatic and supportive... 

Budesonide is used for inflammatory bowel disease. It has a high first pass metabolism. It has efficacy in the terminal ileum and the right colon. Budesonide in comparison with prednisolone has been associated with fewer bone density losses and unlike other corticosteroids has little influence on the hypothalamic-pituitary-adrenal axis. 

There are a number of corticosteroids that are used in pulmonology as inhalation medications. For rhinitis sprays may be used which also contain corticosteroids. Coricosteroids in these topical medications include beclometasone, fluticasone, mometa-sone and also budesonide. 

IX.b.3.1. Corticosteroids. These reverse symptoms associated with active inflammation, but should be used with caution, if at all, in those suspected of having disease complicated by flstulation and abscesses. Although prednisone has been the standard treatment, the poorly absorbed steroid budesonide has shown equivalence of action whilst having reduced suppression of the pituitary-adrenal axis. The effect of corticosteroids is, in general terms, equivalent to that of an elemental diet. 

Presently, inhaled steroids (up to the equivalent of BDP 1000 pg/d, budesonide 800 pg/d, fluticasone 500 pg/d) should be given to patients who show an objective response to either oral or inhaled steroids (s. corticosteroid reversibility testing). For those patients who experience no symptomatic relief, the currently available evidence does not support the use of ICS for alteration of the natural history of the disease. Nevertheless, corticosteroids are effective in treating acute exacerbations in COPD and taking patients of off their ICS regimen may lead to deterioration. Oral corticosteroids (e.g. 40 mg prednisolone for ten days) are recommended for exacerbations, if... 

Corticosteroids for rectal use betamethasone sodium phosphate budesonide... 

Corticosteroids beclomethasone dipropionate budesonide fluticasone propionate... 

Therapeutic pyramid approach to inflammatory bowel diseases. Treatment choice is predicated on both the severity of the illness and the responsiveness to therapy. Agents at the bottom of the pyramid are less efficacious but carry a lower risk of serious adverse effects. Drugs may be used alone or in various combinations. Patients with mild disease may be treated with 5-aminosalicylates (with ulcerative colitis or Crohn s colitis), topical corticosteroids (ulcerative colitis), antibiotics (Crohn s colitis or Crohn s perianal disease), or budesonide (Crohn s ileitis). Patients with moderate disease or patients who fail initial therapy for mild disease may be treated with oral corticosteroids to promote disease remission immunomodulators (azathioprine, mercaptopurine, methotrexate) to promote or maintain disease remission or anti-TNF antibodies. Patients with moderate disease who fail other therapies or patients with severe disease may require intravenous corticosteroids, anti-TNF antibodies, or surgery. Natalizumab is reserved for patients with severe Crohn s disease who have failed immunomodulators and TNF antagonists. Cyclosporine is used primarily for patients with severe ulcerative colitis who have failed a course of intravenous corticosteroids. TNF, tumor necrosis factor. 

Inhaled corticosteroids Pulmicort respules (AstraZeneca) Budesonide Inhalation suspension 0.25 mg/2 mL, 0.5 mg/2 mL. In single-dose envelopes EDTA... 

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