Budesonide is a drug belonging to the group of corticosteroids. It is a component of drugs used in the treatment of asthma and chronic obstructive pulmonary disease. This drug is very often prescribed by pulmonologists, allergists and GPs.
Budesonideis most commonly used in the form of inhalation powder in hard capsules, nebuliser suspension, nasal spray suspension, but it can also be found in rectal foam, tablets or oral capsules.
Action
Glucocorticosteroids have an anti-inflammatory effect. They are given to the patient when an inflammatory process of autoimmune origin is taking place in his body, e.g.
- rheumatoid arthritis,
- lupus erythematosus,
- nodular periarteritis,
- multiple sclerosis,
- Hashimoto's disease,
- Graves' disease.
They are also used as immunosuppressive drugs, i.e. drugs that inhibit the immune reaction of the body, also to prevent the patient from rejecting a transplant. The most common use of budesonide is in the treatment of allergies in which asthma, asthma, or allergic rhinitis are observed.
The mechanism of action of glucocorticosteroids is based on the attachment of a steroid molecule to its receptor located inside the cell. Such an active combination changes the DNA sequence on the cell nucleus and causes the cell to produce proteins responsible for anti-inflammatory effects.
Literature emphasizes that regular use of inhaled budesonide or in the form of nebulizing aerosols reduces chronic inflammation in the airways of patients suffering from asthma.
The patient experiences an improvement in lung function and a reduction in the symptoms of a chronic disease. Asthma forces the patient to receive a continuous supply of the drug because the disease is incurable and only conscious, regular use of glucocorticosteroids along with supporting medications can control the disease and reduce the frequency of asthma attacks to a minimum.
The patient must be aware of the side effects of chronic corticosteroid therapy, and should be able to recognize disturbing symptoms that maytestify to the deterioration of he alth. Topical steroids, i.e. by inhalation or aerosol, only work at the site of administration. Such a procedure significantly reduces the occurrence of systemic side effects, but does not reduce them to zero.
Indications
The main indication for the use of budesonide is bronchial asthma or chronic obstructive pulmonary disease, the so-called COPD.
This drug is only used to reduce chronic inflammation and as takinie to stop an asthma attack. If the patient experiences an attack of breathlessness, he should use a short-acting beta-2-agonist that inhibits bronchospasm during the attack and provides immediate relief from breathlessness.
Dosage
Asthma treatment is a highly personalized process. The attending physician decides the frequency of the doses to be administered and the size of the doses. The doctor uses treatment regimens that are appropriate to the patient's case, but may modify the dose slightly based on how the patient responds to the drug and the severity of his disease. The golden rule in the treatment of each patient with glucocorticosteroids is to use the lowest effective dose in the therapy.
Classically, budesonide is taken by the patient every day at regular times. Each modification of the treatment is carried out under the supervision of a physician, the changes are introduced gradually. The need to increase the dose arises when the patient's symptoms worsen despite compliance with the recommendations.
Treatment with budesonide inhalation powder in hard capsules may be started from the age of 6, but this method is preferred in adults. In children, on the other hand, the use of a nebuliser suspension is very popular. However, if the doctor decides to include powder inhalation in the child's therapy, the child should take the drug under the supervision of an adult.
Contraindications
Budesonide cannot be used by people who are hypersensitive to this substance and people with active pulmonary tuberculosis.
Warnings and drug interactions
It is very important that the attending physician explains exactly what the purpose of taking the substance is and make him aware that it is not an appropriate measure to stop the attack of dyspnea.
Budesonide is taken to prevent it, reduce the inflammatory response in the asthmatic's respiratory system, and make it easier for the patient to breathe. The drug should be used regularly, even in the absence of asthma symptoms. You should take another medication prescribed by your doctor to stop the acute bronchospasm that accompanies an asthma attack.
You shouldTake special care when treating patients with latent pulmonary tuberculosis or if a viral or fungal infection of the respiratory tract is suspected. Corticosteroids naturally suppress the immune system's response, making the body unable to fight the infection.
Throughout the treatment period, the attending physician will certainly be forced to introduce changes in the dosage or even change the drug to a more effective one. If you find that you need to take a bronchodilator more often to stop an episode of asthma, ergo attacks occur more often despite the patient's adherence to the corticosteroid regimen, it means that he or she needs to see a doctor for a re-evaluation and modification of the treatment. The changes may be based on increasing the dose of corticosteroids or adding oral steroids to the treatment.
Paradoxical bronchospasm may occasionally occur following administration of inhaled corticosteroids. This situation is not frequent, but the patient must be aware of the dangers it poses.
In the event of a sudden bronchospasm following administration of budesonide, the patient should take a rapid-acting bronchodilator immediately, stop inhaling corticosteroids, and contact their physician for further treatment arrangements.
The patient should inform the attending physician about each drug taken for a long time. Budesonide should be used with caution in patients who are concomitantly taking:
- itraconazole,
- atazanavir,
- ketoconazole,
- ritonavir,
- nelfinavir,
- amiodaron,
- clarithromycin.
In the case of pregnant women, budesonide should only be administered under medical supervision. Breastfeeding women are theoretically allowed to take budesonide because the plasma concentration of the breastfed child is 1/600 of that in the mother's body, however there are no official studies to support the safety of budesonide while breastfeeding.
Side effects
Characteristic side effects that commonly affect patients taking inhaled corticosteroids are:
- pneumonia that is more common in COPD patients,
- blurred vision,
- cough,
- oral candidiasis,
- hoarseness,
- dry mouth,
- throat irritation.
Patients very often do not combine hoarseness, dryness and oral candidiasis with the corticosteroids they take. They report to the pharmacy in search of a drug for the existing onessymptoms, i.e. throat lozenges with Icelandic lichen or honey and lemon, a throat spray that removes irritation and pain, e.g. Tantum verde spray.
Lozenges worth paying attention to are chlorchinaldin, this drug not only has antibacterial but also antifungal properties.
Chlorchinaldin has been shown in the Summary of Product Characteristics to be effective against Candida fungi, which most commonly cause oral infections in patients taking inhaled corticosteroids. Of course, if a patient notices a developing infection, the safest option is to see a doctor who will prescribe topical or systemic antifungal medications.However, it is worth mentioning that in order to reduce the risk of these side effects, the patient should rinse the mouthwash with the mouthwash after taking the drug by inhalation. As a result, any small amount of budesonide that remains in the mouth and causes local side effects will be flushed away.
There are many products and even medications for mouthwash on the market with additional antifungal and antibacterial properties. It is worth asking at the pharmacy for a mouthwash with benzydamine, chlorhexidine, medicinal sage. These substances reduce oral inflammation and have an antimicrobial effect.
It is worth getting interested in inhalation chambers, the so-called spacers. It is a device that can be purchased for an inhaler, reusable. The spacer provides additional space in the form of a tube or chamber between the inhaler and the patient's mouth. This makes it possible to take the medicine with 5-10 gently inhales instead of one coordinated inhalation.
It is a great convenience, especially for small patients who often have problems with the effective administration of the drug. It is precisely when you cannot breathe the medicine that some of the substance remains in your mouth. So the spacer reduces the risk of side effects in the mouth and throat area
The risk of systemic side effects is minimal with the use of inhaled corticosteroids. Nevertheless, the patient should know how to recognize them and when to visit the treating physician. Possible side effects of inhaled corticosteroids include:
- adrenal suppression,
- excessive secretion of adrenal hormones,
- Cushing's syndrome,
- growth retardation in children and adolescents,
- decrease in bone mineral density, which results in symptoms similar to osteoporosis,
- cataract
- iglaucoma.
When the patient notices the deterioration of his eyesight, he should see an ophthalmologist and inform him about the symptoms and medications. Behavioral changes, especially in children, may occur after corticosteroids, as manifested by:
- aggression,
- low mood
- or psychomotor agitation.