pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2014-0-3-113-120pulmo-406Research ArticleОБЗОРЫREVIEWБЕЗОПАСНОСТЬ ИНГАЛЯЦИОННЫХ ГЛЮКОКОРТИКОСТЕРОИДОВ В ТЕРАПИИ БРОНХИАЛЬНОЙ АСТМЫSAFETY OF INHALED CORTICOSTEROIDS IN THE THERAPY OF BRONCHIAL ASTHMAНенашеваН. М.NenashevaN. M.

д. м. н., профессор кафедры клинической аллергологии ГБОУ ДПО РМАПО; тел.: (499) 196-19-54

1444031@gmail.comГБОУ ДПО "Российская медицинская академия последипломного образования" Минздрава России: 123995, Москва, ул. Баррикадная, 2 / 1РоссияState Institution Russian Medical Postgradual Academy, the Health Ministry of Russia; Moscow, RussiaRussian Federation20142806201403113120Copyright © Ненашева Н.М., 20142014Ненашева Н.М.Nenasheva N.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/406

Основными препаратами, с помощью которых обеспечивается длительный контроль над бронхиальной астмой (БА), являются ингаляционные глюкокортикостероиды (иГКС), обладающие выраженным противовоспалительным эффектом. При воздействии иГКС снижается уровень смертности при БА, улучшается функция легких, облегчаются симптомы, уменьшается число обострений и повышается качество жизни пациентов. Молекулы иГКС могут различаться по своему терапевтическому индексу, но в эквипотентных дозах они одинаково эффективны. Максимальный эффект иГКС проявляется уже при применении низких / средних доз, предпочтительных для длительного лечения БА. При корректном использовании в диапазоне низких / средних доз иГКС проявляется мало нежелательных эффектов (НЭ), однако риск их возникновения увеличивается с повышением доз.Данная статья посвящена фармакокинетическим свойствам и механизму действия иГКС, возможным локальным и системным НЭ и мерам их профилактики.

Inhaled corticosteroids (ICS) are the basic medication providing long-term control of asthma. They have a significant antiinflammatory effect leading to decreased mortality, improved lung function, relief of symptoms, reduced exacerbation rate and improved quality of life. Different ICS molecules have different therapeutic index but they act equally in equipotent doses. The maximal effect of ICS is generally seen even in mild to moderate doses which are preferable for regular treatment. Adequate use of mild to moderate doses of ICS is typically accompanied by lower rate of adverse events but the risk of adverse events increase as the dose increase.Pharmacokinetic properties and mechanism of ICS action, potential systemic and local adverse events and ways to prevent their occurrence have been described in the article.

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The authors declare that there are no conflicts of interest present.