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Inhaled glucocorticoid (ICS) is currently the strongest local airway anti-inflammatory drug, which exerts an anti-inflammatory effect by affecting cells and molecules related to inflammation. Commonly used ICS are budesonide, fluticasone propionate, beclomethasone propionate, and ciclesonide. What is the difference between these four ICS?

I. The same inhalant, but different indications

Budesonide aerosol is only approved for the treatment of bronchial asthma; the use of albuterol and budesonide nebulizer to inhale budesonide powder is approved for the treatment of bronchial asthma and chronic obstructive pulmonary disease. Whether it is aerosol or dry powder inhalation, fluticasone propionate, beclomethasone propionate, and ciclesonide are only approved for the treatment of bronchial asthma. why?

1. Different lesions:

The main lesions of bronchial asthma are the bronchi, and the main lesions of chronic obstructive pulmonary disease (COPD) are the terminal bronchi and alveoli.

2. The size of atomized particles is different:

The fog particles with a particle size of 5~10μm are mainly deposited in the oropharynx, the fog particles with a particle size of 3~5μm are mainly deposited in the lungs (bronchi, bronchiole), and the fog particles with a particle diameter of <3μm are mainly deposited in the terminal bronchi and alveoli.

II. Different inhalants have different systemic adverse reactions

The use of albuterol and budesonide nebulizer inhaled corticosteroids is a topical treatment. Any glucocorticoid that enters the blood can produce systemic adverse reactions, such as adrenal gland hypofunction and growth slowdown in children.

The drugs deposited in the oropharynx can not only cause throat irritation, coughing, hoarseness, and Candida infection in the oropharynx but also cause systemic adverse reactions after being absorbed through the gastrointestinal tract. In order to minimize local adverse reactions in the oropharynx, patients should rinse their mouths with water immediately after each inhalation of the drug.

Drugs deposited in the alveoli: The alveoli have a huge surface area, and the drugs deposited in the alveoli can be quickly absorbed and can cause systemic adverse reactions. Different types of inhaled glucocorticoids (ICS) have the same curative effect. Due to different pharmacokinetic characteristics, systemic adverse reactions are different.

The first pass of budesonide, fluticasone, and ciclesonide is eliminated. The oral bioavailability is lower than that of beclomethasone dipropionate, and the systemic adverse reactions are also less than that of beclomethasone dipropionate. For patients and children who need high doses of ICS, albuterol and budesonide nebulizer is recommended for inhalation of budesonide and fluticasone.

III. Different inhalants and different medication groups

Caution should be used when using albuterol and budesonide nebulizer: there is insufficient evidence for the safety of use during pregnancy and breastfeeding. Only when the expected benefit to the mother exceeds the potential risk to the fetus or newborn should the drug be considered.

Special reminder: Prednisone, prednisolone, and dexamethasone can be used to treat asthma when administered orally or intravenously, but they have no anti-asthmatic activity when administered by inhalation.

Feellife provides you with professional albuterol and budesonide nebulizer to protect you and your family's healthy life. Besides albuterol and budesonide nebulizers, we also have portable nebulizer with mask, portable inhaler, travel size nebulizer, etc. Different kinds of nebulizers have their own characteristic. So come to Feellife to find your own nebulizer!