In this episode, Dr. Busti reviews inhaled corticosteroids (ICS) as essential anti-inflammatory therapy in asthma and some patients with COPD. Inhaled corticosteroids remain the first-line maintenance treatment for persistent asthma, reducing exacerbations, hospitalizations, and mortality. In COPD, their use is selective—mainly in moderate to severe disease with frequent exacerbations and eosinophils ≥100 cells/µL, often in combination with LABA/LAMA therapy.
The episode highlights key agents (beclomethasone, budesonide, ciclesonide, fluticasone, mometasone), dose-equivalence ranges, and device technique differences (MDI, DPI, nebulizer). Adverse effects of ICS include dysphonia, oropharyngeal candidiasis, and rare systemic absorption effects such as adrenal suppression or bone loss; proper inhalation technique and mouth rinsing help minimize risks.
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00:00 Introduction to Inhaled Corticosteroids (ICS)
01:07 Why ICS Work in Asthma vs COPD: Pathophysiologic Differences
03:30 ICS Indications: First-Line Asthma Therapy & Select COPD Use
03:49 Mechanism of Action: Airway Inflammation, Edema & Remodeling
07:16 Anatomy Impact on Drug Delivery: Absorption & AEs
14:10 Airway Anatomy Deep Dive: Conducting vs Respiratory Zones
17:05 Steroid Effects on Beta-2 Receptors & Bronchodilator Response
21:00 ICS Dosing: Low, Medium, High Doses Across Age Groups
23:55 Adverse Effects: Thrush, Adrenal Suppression, Bone Density
26:40 Clinical Considerations: Neutrophil vs Eosinophil Inflammation
34:10 Inhaler Technique & Counseling Points: MDI, DPI, Nebulizer
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#InhaledCorticosteroids #AsthmaPharmacology #pharmacology #Pulmonology #medicaleducation
Disclaimer:
This content is for educational purposes only and is not intended to provide medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider regarding a medical condition.
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