支气管痉挛对吸入性氟替卡松或布地奈德血药浓度的影响
2007/11/02
研究目的：观察乙酰甲胆碱所诱发的支气管痉挛对20例轻度哮喘患者吸入氟替卡松及或布地奈德后血药浓度的影响。
结果显示：乙酰甲胆碱诱导的支气管痉挛能显著降低哮喘患者吸入性氟替卡松或布地奈德的血药浓度（前者更显著）。结果提示哮喘患者气道管径的变化可能影响吸入性糖皮质激素的疗效。
（蔡闯 广州医学院第一附属医院 广州呼吸病研究所 510012 摘译）
（Br J Clin Pharmacol. 2007; 64: 439-444）
Plasma concentrations of fluticasone propionate and budesonide following inhalation: effect of induced bronchoconstriction
Mortimer KJ, Tattersfield AE, Tang Y, Wu K, Lewis S, Hochhaus G, Harrison TW.
Aims
To determine whether and to what extent bronchoconstriction affects plasma concentrations of fluticasone and budesonide following inhalation.
Methods
Twenty people with mild asthma inhaled 1000 μg fluticasone (Accuhaler?) plus 800 μg budesonide (Turbohaler?) on two visits. On one occasion, prior to drug inhalation, FEV1 was decreased by at least 25% using inhaled methacholine. Plasma
drug concentrations were measured for each drug over 5 h and area under the plasma
concentration-time curve (AUC(0,5 h)) compared between visits.
Results
The mean difference in FEV1 prior to drug inhalation on the 2 days was 33%.
AUC(0,5 h) values for fluticasone and budesonide were lower by a median of 60%
(IQR 36–75) and 29% (IQR 2–44), respectively, when administered following bronchoconstriction; the reduction was greater for fluticasone than for budesonide,P＝0.007.
Conclusions
The lower plasma concentrations of fluticasone and, to a lesser extent, budesonide seen when the drugs were inhaled following induced bronchoconstriction, is likely to reflect variations that will occur with fluctuations in airway caliber in asthma.
Keywords asthma, inhaled corticosteroid, pharmacology
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