Budesonide: Difference between revisions
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*Allergy to class/drug | *Allergy to class/drug | ||
*[[Asthma]], acute | *[[Asthma]], acute | ||
*[[ | *[[Acute asthma exacerbation]] | ||
*Bronchospasm, acute | |||
*Avoid abrupt withdrawal | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*[[Anaphylaxis]] | |||
*Bronchospasm | |||
*Hypersensitivty reaction, incl. rash | |||
*[[Angioedema]] | |||
*Adrenal suppression | |||
*[[Cushing syndrome]] | |||
*Hypercorticism | |||
*Growth suppression | |||
*[[Eosinophilia]] | |||
*[[Churg-Strauss syndrome]] | |||
*[[Glaucoma]] | |||
*Cataracts | |||
*Osteoporosis | |||
===Common=== | ===Common=== | ||
*[Upper respiratory infection]] | |||
*Rhinitis | |||
*[[Cough]] | |||
*[[Otitis media]] | |||
*Viral infection | |||
*[[Candidiasis]], oral | |||
*[[Gastroenteritis]] | |||
*[[Vomiting]] | |||
*[[Diarrhea]] | |||
*[[Abdominal pain]] | |||
*[[Epistaxis]] | |||
*[[Conjunctivitis]] | |||
*[[Rash]] | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 2.3 hr | ||
*Metabolism: | *Metabolism: Liver; CYP450: 3A4 substrate | ||
*Excretion: | *Excretion: Urine 60%, feces | ||
==Mechanism of Action== | ==Mechanism of Action== | ||
Inhibits multiple inflammatory cytokines and produces multiple glucocorticoid adn mineralcorticoid effects. Exact mechanism unknown. | |||
==Comments== | ==Comments== | ||
Revision as of 19:27, 15 November 2016
Administration
- Type: Inhaled corticosteroid
- Dosage Forms: 3 DR
- Routes of Administration: Inhaled
- Common Trade Names: Pulmicort
Adult Dosing
- 1.5-2 mg NEB q 6 hr
- Do not mix with other nebulized medications and rinse mouth after use
Pediatric Dosing
- Asthma maintenance
- 1-8 yo w/ prior bronchodilator alone
- 0.25-0.5 mg/day NEB divided qd-BID
- Start: 0.5 mg/day
- Max: 0.5 mg/day. Titrate to lowest effective dose.
- 0.25-0.5 mg/day NEB divided qd-BID
- 1-8 yo w/ prior inhaled steroid
- 0.25-1 mg/day NEB divided qd-BID
- Start: 0.5mg/day
- Max: 1 mg/day. Titrate to lowest effective dose.
- 0.25-1 mg/day NEB divided qd-BID
- 1-8 yo w/ prior oral steroid
- 0.25-1 mg/day NEB divided qd-BID
- Start: 1 mg/day
- Max: 1 mg/day. Titrate to lowest effective dose. Taper oral steroid gradually after >1 week.
- 0.25-1 mg/day NEB divided qd-BID
- 1-8 yo w/ prior bronchodilator alone
- Eosinophilic esophagitis
- <11 yo: 1 mg PO qd x4-12 weeks
- Mix 1 mg/2mL NEB w/ 5 g sucralose to form PO slurry.
- Avoid food/drink x30 min after each dose
- 11+ yo: 2 mg PO qd x4-12 weeks
- Mix 2 mg/4mL NEB w/ 10 g sucralose to form PO slurry.
- Avoid food/drink x30 min after each dose
- <11 yo: 1 mg PO qd x4-12 weeks
Special Populations
- Pregnancy Rating: B; drug of choice for pregnant pts w/ persistent asthma
- Lactation risk: L3; Safety unknown
Renal Dosing
- Adult: Not defined
- Pediatric: Not defined
Hepatic Dosing
- Adult: Not defined. Monitor closely with impairment.
- Pediatric: Not defined. Monitor closely with impairment.
Contraindications
- Allergy to class/drug
- Asthma, acute
- Acute asthma exacerbation
- Bronchospasm, acute
- Avoid abrupt withdrawal
Adverse Reactions
Serious
- Anaphylaxis
- Bronchospasm
- Hypersensitivty reaction, incl. rash
- Angioedema
- Adrenal suppression
- Cushing syndrome
- Hypercorticism
- Growth suppression
- Eosinophilia
- Churg-Strauss syndrome
- Glaucoma
- Cataracts
- Osteoporosis
Common
- [Upper respiratory infection]]
- Rhinitis
- Cough
- Otitis media
- Viral infection
- Candidiasis, oral
- Gastroenteritis
- Vomiting
- Diarrhea
- Abdominal pain
- Epistaxis
- Conjunctivitis
- Rash
Pharmacology
- Half-life: 2.3 hr
- Metabolism: Liver; CYP450: 3A4 substrate
- Excretion: Urine 60%, feces
Mechanism of Action
Inhibits multiple inflammatory cytokines and produces multiple glucocorticoid adn mineralcorticoid effects. Exact mechanism unknown.