Allergy.  1994 Dec;14(4):674-686.

The Effects of Different Delivery Methods of Inhaled Budesonlde on the Plasma Cortisol Concentration

• Lee YC
• Rhee YK
• Lee YS
• Rhee BH
• Yim ST

Abstract

Inhaled budesonide "a synthetized glucocorticoid" is now established as effective drug in the management of chronic obstructive pulmonary disease and chronic bronchial asthma. This drug has high topical anti-inflammatory effects and low systemic effects. Inhaled budesonide may produce systemic effects including adrenocortical suppresion. This study was performed to determine the effects of inhaled budesonide on the adreno-cortical suppression by different delivery methods in twenty-five patients with chronic obstructive pulmonary disease or bronchial asthma. The adrenocortical function was assessed by a measurement of serum cortisol concentration at 8 A.M. and free cortisol value in 24-hour urine at interval. No steroid was administered during the pretreatment period of 10days at least, and the final 6days of the study. Each patients inhaled budesonide aerosol in daily doses of 800/micro gram for 12days. The dose was delivered by the three different methods which were metered dose inhal er(MDI), large spacing device attached to MDI (MDI with LSD) and Turbuhaler. The levels of serum cortisol and 24 hour urinary free cortisol value were decreased during the treatment period in patients inhaled budesonide delivered by MDI, But not significantly decreased in patients delivered by MDI with LSD and Turbuhaler. These results showed that the endogenous cortisol secretion was more suppressed after inhalation of MDI than MDI with LSD and Turbuhaler. Therefore, MDI with LSD and Turbuhaler are more physiologic delivery method than MDI.

MeSH Terms

Asthma
Budesonide
Humans
Hydrocortisone*
Inhalation
Lysergic Acid Diethylamide
Plasma*
Pulmonary Disease, Chronic Obstructive
Budesonide
Hydrocortisone
Lysergic Acid Diethylamide