Profilul de siguranță al corticoterapiei inhalatorii | [Safety profile of inhaled corticosteroids]

Abstract

Inhaled corticosteroids are the mainstay of asthma treatment, yet they are underused due to their potential local and systemic side effects. Under usage of inhaled corticosteroids is directly related to asthma mortality, while the delay in introducing inhaled corticosteroids in asthma treatment leads to poor asthma control and irreversible lung remodeling, both in children and in adults. The pharmacokinetics and pharmacodynamics of inhaled corticosteroids – particle size, oral and systemic bioavailability, on-site activation, lipid and plasma protein conjugation, receptor affinity, and systemic and pulmonary clearance- strongly influence both the potency and the side effects of the inhaled corticosteroid. The ideal inhaled corticosteroid has high potency and minimal or no side effects and could be designed according to the pharmacokinetics and pharmacodynamics safety rules. The third-generation inhaled corticosteroids, “manufacturer design”, aim for this safety profile.