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Pharmacodynamics and clinical efficacy of inhaled glucocorticosteriods in patients with bronchial asthma exacerbation

Abstract

The aim of the study was to evaluate pharmacodynamics and clinical efficacy of inhaled glucocorticosteriods (IGCS) when used via nebulizer or spacer in patients with bronchial asthma (BA) exacerbation needed to be admitted to a hospital.
The study involved 40 patients with BA exacerbation (the average age was 40.1 ±5 ydars, males/females ratio was 27.5%/72.5%) having the forced expiratory volume for 1 sec (FEV1) of 30-65% of the predictive values.
The patients were randomly divided to 3 groups: 13 patients received budesonide suspension via nebulizer in the dose of 1000 meg once, 11 patients received flunisolide hemihydrate in a form of an aerosol inhaler with a high volume spacer (1 I) in the dose of 250 meg every 10 min during 2.2 h (the total dose was 3250 meg).
Other 16 patients were given oral prednisolone 40 mg once. The therapy efficacy was assessed with regard to FEV1 dynamics in 1, 3 and 6 h starting the therapy. The treatment safety was evaluated regarding the patients’ complaints, arterial blood pressure level, heart beat rate and a length of the QT interval.
All the patients demonstrated the FEV1 growth which was the higher in the patients treated with budesonide.
The maximal FEV1 rowth level (189.1% of the initial value) in this group was noted in 6 h after beginning the treatment. Flunisolide patients showed the maximal FEV1 increase (150% of the initial value) in 1 h of the therapy, but there was no the further FEV1, growth and for the next 5 h there was no any significant changes in the FEV1, level.
The high doses of IGCS in patients with moderate and severe BA exacerbations who had not received GCS before were more effective and an action came faster compared with those of the oral prednisolone. The less doses of budesonide influenced to bronchial passability parameters more considerable than flunisolide.

About the Authors

A. N. Tsoy
ММА им. И.М.Сеченова
Russian Federation


L. S. Arzhakova
ММА им. И.М.Сеченова
Russian Federation


V. V. Arkhipov
ММА им. И.М.Сеченова
Russian Federation


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Review

For citations:


Tsoy A.N., Arzhakova L.S., Arkhipov V.V. Pharmacodynamics and clinical efficacy of inhaled glucocorticosteriods in patients with bronchial asthma exacerbation. PULMONOLOGIYA. 2002;(3):88-92. (In Russ.)

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