Inhaled Corticosteroids

Inhaled corticosteroids are medications that improve breathing by decreasing lung inflammation. They are primarily used in clients with persistent asthma, meaning those who have asthmatic symptoms more than 2 days per week. Asthma is characterized by chronic inflammation in the lungs, as well as asthma exacerbations or attacks, where certain triggers, such as viruses, allergens, stress, aspirin or other NSAIDs and exercise, lead to reversible bronchial smooth muscle spasms and mucus production, both of which make it hard to breathe.

As a result, clients experience symptoms like dyspnea, wheezing, chest tightness, and coughing. Inhaled corticosteroids help decrease the frequency of symptoms and prevent exacerbations. Inhaled corticosteroids can also be used in clients with chronic obstructive lung disease, or COPD, to prevent exacerbation and slow the progression of the disease.

Now, commonly used inhaled corticosteroids include fluticasone, beclomethasone, budesonide, and mometasone. These medications are typically used as maintenance therapy to help control the underlying lung inflammation, and are often combined with inhaled bronchodilators, such as long acting beta-2 agonists like salmeterol, which provide immediate relief of symptoms by inducing airway smooth muscle relaxation.

Now, once in the lungs, inhaled corticosteroids enter the respiratory epithelial cells and suppress the expression of certain genes that code for inflammatory proteins. This leads to decreased movement of inflammatory and immune cells into the bronchi and lungs, as well as decreased production and release of inflammatory mediators like histamine and leukotrienes. As a result, there’s reduced airway inflammation and edema, as well as decreased mucus production, which ultimately leads to airway dilation and improved air flow.