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Pulmicort is the brand name of the drug Budesonide. It is a corticosteroid which is used for the long-term or prolonged management of chronic respiratory infections such as chronic obstructive pulmonary disease (COPD) and asthma. It has been prepared in many formulations which include as an inhaler, rectal formulas, a pill, and nasal sprays.
It is a corticosteroid/ steroid agent, a gastrointestinal agent and an inhalant.
Mode Of Action
As a treatment for inflammatory bowel disease, this drug reduces the rate of inflammation of the colon by curbing the movement of PMNs (polymorphonuclear leukocytes) _ these are types of white blood cells which are released by the body's immune system when there is an infection or skin breakage.
Budesonide paralyzes the lysosomal and cell membranes, inhibits the formation of granulocyte aggregates at the site of injury or infection and raises the levels of serum vitamin A concentration. It restricts the release of inflammatory mediators such as prostaglandins and cytokines. By performing all these activities, this drug prevents inflammation in the colon by lowering the body's immune system.
The same way it does to the colon is the same thing that happens in the respiratory system. It prevents inflammation of the airways and ensures an asthmatic patient has a patent airway.
Pharmacokinetics of the drug
Once in the body, the drug is absorbed and has a low bioavailability of 6-13%. The drug starts showing its effect from the first 24 hrs to two weeks. It reaches peak plasma levels between 1 to 2 hours. The distribution of budesonide is 85% - 90%. The volume of distribution is 3 L per Kg. The drug is metabolized in the liver and may interact with various drugs since it utilizes the CYP3A4 enzymes. After been metabolized, the drug is broken down into two products. These metabolites include 6-beta hydroxy budesonide and 16-Alpha hydroxyprednisolone. The elimination half-life of budesonide is between two to three hours. It is later secreted in urine at 60% and through the gastrointestinal tract at 40%.
Usage And Dosage
As quoted above, budesonide is a drug that can be used in many conditions. They include:
It is used in asthma to open up the airways. In this condition, Budesonide is nebulizer via a mask to act as a maintenance dosage of asthma. It is also used as a preventive drug for asthma.
The dosage of budesonide inhaler for the maintenance treatment of asthma is as follows
The patient should inhale 360 mcg twice a day while some patients may get 180 mcg twice daily as prescribed by the doctor or as per the patient's symptoms. However, one should not exceed a maximum of 720 mcg daily. The budesonide inhalation suspension should be given via a jet nebulizer which is channeled to an air compressor via a mask. Ensure the mask is the best fitting for the client to enable optimum nebulization. This also saves the drug from escaping through the sides of the mask.
Inflammatory Bowel Disease
In this case, budesonide is administered as a delayed release pill to work effectively. It manages Crohn's disease within months. The maintenance dose of budesonide for Crohn's disease should be no more than 3 months. The drug works to trigger the induction of remission with patients who come with an active ulcerative colitis. The current guidelines put budesonide as the drug recommended for microscopic colitis. It is also recommended for lymphocytic and collagenous colitis.
Rhinitis Caused By Allergy
Budesonide nasal spray is used for the management of rhinitis commonly brought about by allergy.
The nasal spray has greatly been used for the treatment of allergic rhinitis and nasal polyps. For ulcerative colitis and inflammatory bowel diseases, the delayed release budesonide pills are used.
Side effects of Budesonide
Just as any other drug that you have heard of, Budesonide inhaler has also some side effects. This side effects are expected and are not life-threatening. However, if you feel that the drug is making your life unbearable to the extent of not being able to accomplish activities of daily living, you should consult your doctor or pharmacist. The side effects of the inhalation dose include: You could have a running, stuffy or a sore in the nose, you could also have a sore throat, hay fever, urge to vomit, gastroenteritis, appetite loss, general body malaise, body aches, upper respiratory tract viral infections, infections of the ear among others. The reportable side effects are those that do not go away after the drug's half-life has ended. This is not a list of all the side effects experienced when taking this drug hence if you find another symptom affecting you, kindly reach out to your doctor.
Drug Interactions With Budesonide
Budesonide interacts with various medications. They are not supposed to be taken concomitantly. It is good to inform your doctor about the drugs that you are taking so that you may have a better management session with budesonide. The following drugs are contraindicated when using this drug. They include Any other corticosteroid drug, antifungal drugs such as ketoconazole, other immunosuppressants such as cyclosporine, clarithromycin, certain anticonvulsants and certain antibiotics such as telithromycin and erythromycin.
Precautions And Contraindications
Before even administering the drug, take the leaflet inside the medication packet and read instructions very carefully as written by the pharmacist. If you have any questions regarding the drug, consult with your doctor. Another thing to note is that the dosage the doctor has prescribed to you depends on your condition and how you are responding to treatment. In children, the dosage is dependent on weight. If symptoms persist or worsens, seek medical review from a professional medical doctor.
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