Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 47
Filter
Add more filters

Publication year range
1.
AAPS PharmSciTech ; 20(4): 152, 2019 Mar 25.
Article in English | MEDLINE | ID: mdl-30911861

ABSTRACT

The current study is concerned with the development and characterization of mixed micelles intended for the dermal delivery of beclomethasone dipropionate, which is a topical corticosteroid used in the management of atopic dermatitis. Mixed micelles were prepared using thin-film hydration technique, employing different concentrations of pluronic L121 with either poloxamer P84 or pluronic F127 with different surfactant mixture-to-drug ratios. The prepared formulae were characterized concerning entrapment efficiency, particle size, and zeta potential. Two formulae were chosen for ex vivo skin deposition studies: one formulated using pluronic L121/poloxamer P84 mixture while the other using pluronic L121/pluronic F127 mixture. The optimum formula with the highest dermal deposition was subjected to morphological examination and was formulated as hydroxypropyl methylcellulose hydrogel. The hydrogel was evaluated regarding viscosity and was subjected to ex vivo deposition study in comparison with the commercially available cream Beclozone®. In vivo histopathological study was conducted for both the hydrogel and Beclozone® in order to evaluate their healing efficiency. In vivo histopathological study results showed that the prepared hydrogel successfully treated sub-chronic dermatitis in an animal model within a shorter period of time compared to Beclozone®, resulting in better patient compliance and fewer side effects.


Subject(s)
Beclomethasone/administration & dosage , Dermatitis/drug therapy , Disease Models, Animal , Drug Carriers/administration & dosage , Hydrogels/administration & dosage , Micelles , Animals , Animals, Newborn , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/chemistry , Anti-Inflammatory Agents/metabolism , Beclomethasone/chemistry , Beclomethasone/metabolism , Biocompatible Materials/administration & dosage , Biocompatible Materials/chemistry , Biocompatible Materials/metabolism , Dermatitis/metabolism , Dermatitis/pathology , Drug Carriers/chemistry , Drug Carriers/metabolism , Drug Evaluation, Preclinical/methods , Hydrogels/chemistry , Hydrogels/metabolism , Male , Mice , Particle Size , Rats , Rats, Wistar , Skin Absorption/drug effects , Skin Absorption/physiology , Surface-Active Agents/administration & dosage , Surface-Active Agents/chemistry , Surface-Active Agents/metabolism
2.
AAPS PharmSciTech ; 19(5): 2335-2345, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29858973

ABSTRACT

The performance of pressurized metered dose inhalers (MDIs) is affected by formulation and device variables that impact delivered dose, aerodynamic particle size distribution, and consequently lung deposition and therapeutic effect. Specific formulation variables of relevance to two commercially available products-Proventil® HFA [albuterol sulfate (AS) suspension] and Qvar® [beclomethasone dipropionate (BDP) solution]-were evaluated to determine their influence on key performance attributes measured experimentally with in vitro cascade impaction studies. These commercial MDIs, utilized as model systems, provided mid-points for a design of experiments (DoE) plan to manufacture multiple suspension and solution MDI formulations. The experimental results were utilized as input variables in a computational dosimetry model to predict the effects of MDI formulation variables on lung deposition. For the BDP solution DoE MDIs, increased concentrations of surfactant oleic acid (0-2% w/w) increased lung deposition from 24 to 46%, whereas changes in concentration of the cosolvent ethanol (7-9% w/w) had no effect on lung deposition. For the AS suspension DoE MDIs, changes in oleic acid concentration (0.005-0.25% w/w) did not have significant effects on lung deposition, whereas lung deposition decreased from 48 to 26% as ethanol concentration increased from 2 to 20% w/w, and changes in micronized drug volumetric median particle size distribution (X50, 1.4-2.5 µm) increased deposition in the tracheobronchial airways from 5 to 11%. A direct correlation was observed between fine particle fraction and predicted lung deposition. These results demonstrate the value of using dosimetry models to further explore relationships between performance variables and lung deposition.


Subject(s)
Albuterol/chemistry , Anti-Inflammatory Agents/chemistry , Beclomethasone/chemistry , Bronchodilator Agents/chemistry , Lung , Metered Dose Inhalers , Administration, Inhalation , Aerosols/chemistry , Aerosols/metabolism , Albuterol/metabolism , Anti-Inflammatory Agents/metabolism , Beclomethasone/metabolism , Bronchodilator Agents/metabolism , Drug Compounding , Particle Size , Suspensions/chemistry , Suspensions/metabolism
3.
J Pharmacol Exp Ther ; 345(2): 308-16, 2013 May.
Article in English | MEDLINE | ID: mdl-23512537

ABSTRACT

Inhaled glucocorticoids, such as beclomethasone dipropionate (BDP), are the mainstay treatment of asthma. However, ≈ 30% of patients exhibit little to no benefit from treatment. It has been postulated that glucocorticoid resistance, or insensitivity, is attributable to individual differences in glucocorticoid receptor-mediated processes. It is possible that variations in cytochrome P450 3A enzyme-mediated metabolism of BDP may contribute to this phenomenon. This hypothesis was explored by evaluating the contributions of CYP3A4, 3A5, 3A7, and esterase enzymes in the metabolism of BDP in vitro and relating metabolism to changes in CYP3A enzyme mRNA expression via the glucocorticoid receptor in lung and liver cells. CYP3A4 and CYP3A5 metabolized BDP via hydroxylation ([M4] and [M6]) and dehydrogenation ([M5]) at similar rates; CYP3A7 did not metabolize BDP. A new metabolite [M6], formed by the combined action of esterases and CYP3A4 hydroxylation, was also characterized. To validate the results observed using microsomes and recombinant enzymes, studies were also conducted using A549 lung and DPX2 liver cells. Both liver and lung cells produced esterase-dependent metabolites [M1-M3], with [M1] correlating with CYP3A5 mRNA induction in A549 cells. Liver cells produced both hydroxylated and dehydrogenated metabolites [M4, M5, and M6], but lung cells produced only the dehydrogenated metabolite [M5]. These studies show that CYP3A4 and CYP3A5 metabolize BDP to inactive metabolites and suggest that differences in the expression or function of these enzymes in the lung and/or liver could influence BDP disposition in humans.


Subject(s)
Anti-Inflammatory Agents/metabolism , Beclomethasone/metabolism , Cytochrome P-450 CYP3A/metabolism , Administration, Inhalation , Cell Line , Chromatography, High Pressure Liquid , DNA Primers , Half-Life , Humans , Isoenzymes/metabolism , Lung/cytology , Lung/enzymology , Lung/metabolism , Polymerase Chain Reaction , Tandem Mass Spectrometry
4.
Int J Immunopathol Pharmacol ; 25(2): 541-6, 2012.
Article in English | MEDLINE | ID: mdl-22697089

ABSTRACT

Polyspecific organic cation transporters (OCTs) in human cell membranes are involved in the uptake, distribution and excretion of cationic compounds. Although their relevance to drug disposition in the liver, small intestine and kidney has been investigated previously, less is known about the influence of these transporters on the pharmacokinetics and pharmacodynamics of inhaled drugs. Drugs that are commonly administered by inhalation for the treatment of respiratory diseases, such as glucocorticoids and cationic ß(2)-agonists, might interact with several of these transporters, which are strongly expressed on the surfaces of airway epithelial cells. We evaluated the expression of OCT3 and measured the in vitro uptake of the short-acting ß(2)-agonist salbutamol (SALB), alone or in combination with corticosterone (CS) and beclomethasone dipropionate (BDP), by bronchial smooth muscle cells. Our results showed that these cells express the OCT3 transporter and that SALB enters the cell in a transporter-independent fashion. Moreover, CS and BDP have different activities on SALB transport inside the cell. CS increases SALB transport and BDP decreases SALB transport, although neither of these effects are statistically significant. A better understanding of these mechanisms might lead to the improved treatment of airway diseases.


Subject(s)
Adrenergic beta-2 Receptor Agonists/metabolism , Albuterol/metabolism , Bronchodilator Agents/metabolism , Muscle, Smooth/metabolism , Myocytes, Smooth Muscle/metabolism , Organic Cation Transport Proteins/metabolism , Beclomethasone/metabolism , Beclomethasone/pharmacology , Biological Transport , Bronchodilator Agents/pharmacology , Cells, Cultured , Corticosterone/metabolism , Corticosterone/pharmacology , Humans , Immunohistochemistry , Muscle, Smooth/drug effects , Myocytes, Smooth Muscle/drug effects , Organic Cation Transport Proteins/drug effects , Organic Cation Transport Proteins/genetics , RNA, Messenger/metabolism , Real-Time Polymerase Chain Reaction
5.
Front Immunol ; 12: 618569, 2021.
Article in English | MEDLINE | ID: mdl-34046029

ABSTRACT

Glucocorticoids are effective drugs for treating immune-related diseases, but prolonged therapy is associated with an increased risk of various infectious diseases, including tuberculosis. In this study, we have used a larval zebrafish model for tuberculosis, based on Mycobacterium marinum (Mm) infection, to study the effect of glucocorticoids. Our results show that the synthetic glucocorticoid beclomethasone increases the bacterial burden and the dissemination of a systemic Mm infection. The exacerbated Mm infection was associated with a decreased phagocytic activity of macrophages, higher percentages of extracellular bacteria, and a reduced rate of infected cell death, whereas the bactericidal capacity of the macrophages was not affected. The inhibited phagocytic capacity of macrophages was associated with suppression of the transcription of genes involved in phagocytosis in these cells. The decreased bacterial phagocytosis by macrophages was not specific for Mm, since it was also observed upon infection with Salmonella Typhimurium. In conclusion, our results show that glucocorticoids inhibit the phagocytic activity of macrophages, which may increase the severity of bacterial infections like tuberculosis.


Subject(s)
Glucocorticoids/adverse effects , Macrophages/drug effects , Macrophages/immunology , Mycobacterium Infections, Nontuberculous/immunology , Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium marinum/drug effects , Mycobacterium marinum/immunology , Phagocytosis/drug effects , Phagocytosis/immunology , Animals , Bacterial Load , Beclomethasone/metabolism , Immunophenotyping , Immunosuppressive Agents/adverse effects , Macrophage Activation/drug effects , Macrophage Activation/genetics , Macrophage Activation/immunology , Macrophages/metabolism , Mycobacterium Infections, Nontuberculous/metabolism , Reactive Oxygen Species/metabolism , Receptors, Glucocorticoid/metabolism , Zebrafish
6.
Int J Pharm ; 545(1-2): 378-388, 2018 Jul 10.
Article in English | MEDLINE | ID: mdl-29678545

ABSTRACT

The aim of the present investigation was to evaluate the influence of liposome formulation on the ability of vesicles to penetrate a pathological mucus model obtained from COPD affected patients in order to assess the potential of such vesicles for the treatment of chronic respiratory diseases by inhalation. Therefore, Small Unilamellar Liposomes (PLAIN-LIPOSOMEs), Pluronic® F127-surface modified liposomes (PF-LIPOSOMEs) and PEG 2000PE-surface modified liposomes (PEG-LIPOSOMEs) were prepared using the micelle-to-vesicle transition (MVT) method and beclomethasone dipropionate (BDP) as model drug. The obtained liposomes showed diameters in the range of 40-65 nm, PDI values between 0.25 and 0.30 and surface electric charge essentially close to zero. The encapsulation efficiency was found to be dependent on the BDP/lipid ratio used and, furthermore, BDP-loaded liposomes were stable in size both at 37 °C and at 4 °C. All liposomes were not cytotoxic on H441 cell line as assessed by the MTT assay. The liposome uptake was evaluated through a cytofluorimetric assay that showed a non-significant reduction in the internalization of PEG-LIPOSOMEs as compared with PLAIN-LIPOSOMEs. The penetration studies of mucus from COPD patients showed that the PEG-LIPOSOMEs were the most mucus-penetrating vesicles after 27 h. In addition, PEG- and PF-LIPOSOMEs did not cause any effect on bronchoalveolar lavage fluid proteins after aerosol administration in the mouse. The results highlight that PEG-LIPOSOMEs show the most interesting features in terms of penetration through the pathologic sputum, uptake by airway epithelial cells and safety profile.


Subject(s)
Beclomethasone/administration & dosage , Glucocorticoids/administration & dosage , Lipids/chemistry , Pulmonary Disease, Chronic Obstructive/drug therapy , Administration, Inhalation , Aerosols , Animals , Beclomethasone/chemistry , Beclomethasone/metabolism , Cell Line , Drug Compounding , Drug Stability , Glucocorticoids/chemistry , Glucocorticoids/metabolism , Humans , Liposomes , Mice , Mucus/metabolism , Permeability , Poloxamer/chemistry , Polyethylene Glycols/chemistry , Pulmonary Disease, Chronic Obstructive/metabolism , Sputum/metabolism , Surface Properties , Technology, Pharmaceutical/methods
7.
Respir Res ; 8: 65, 2007 Sep 20.
Article in English | MEDLINE | ID: mdl-17883839

ABSTRACT

BACKGROUND: The therapeutic effect of inhaled corticosteroids (ICS) may be affected by the metabolism of the drug in the target organ. We investigated the in vitro metabolism of beclomethasone dipropionate (BDP), budesonide (BUD), ciclesonide (CIC), and fluticasone propionate (FP) in human lung precision-cut tissue slices. CIC, a new generation ICS, is hydrolyzed by esterases in the upper and lower airways to its pharmacologically active metabolite desisobutyryl-ciclesonide (des-CIC). METHODS: Lung tissue slices were incubated with BDP, BUD, CIC, and FP (initial target concentration of 25 microM) for 2, 6, and 24 h. Cellular viability was assessed using adenosine 5'-triphosphate content and protein synthesis in lung slices. Metabolites and remaining parent compounds in the tissue samples were analyzed by HPLC with UV detection. RESULTS: BDP was hydrolyzed to the pharmacologically active metabolite beclomethasone-17-monopropionate (BMP) and, predominantly, to inactive beclomethasone (BOH). CIC was hydrolyzed initially to des-CIC with a slower rate compared to BDP. A distinctly smaller amount (approximately 10-fold less) of fatty acid esters were formed by BMP (and/or BOH) than by BUD or des-CIC. The highest relative amounts of fatty acid esters were detected for BUD. For FP, no metabolites were detected at any time point. The amount of drug-related material in lung tissue (based on initial concentrations) at 24 h was highest for CIC, followed by BUD and FP; the smallest amount was detected for BDP. CONCLUSION: The in vitro metabolic pathways of the tested ICS in human lung tissue were differing. While FP was metabolically stable, the majority of BDP was converted to inactive polar metabolites. The formation of fatty acid conjugates was confirmed for BMP (and/or BOH), BUD, and des-CIC.


Subject(s)
Anti-Allergic Agents/metabolism , Glucocorticoids/metabolism , Lung/metabolism , Adult , Androstadienes/metabolism , Beclomethasone/metabolism , Budesonide/metabolism , Cell Survival/drug effects , Cell Survival/physiology , Fluticasone , Humans , In Vitro Techniques , Male , Middle Aged , Pregnenediones/metabolism
8.
Monaldi Arch Chest Dis ; 67(1): 30-8, 2007 Mar.
Article in English | MEDLINE | ID: mdl-17564282

ABSTRACT

BACKGROUND AND AIM: Compliance with long-term inhaled therapy in asthma is often poor, but it is likely to be improved with a simplified administration, once daily. The present study was designed to assess whether, in childhood asthma, a single dose of nebulized beclomethasone dipropionate once daily was as effective and safe as the same total daily dose administered twice daily. METHODS: Asthmatic children, not treated with inhaled steroids for at least a month preceding the study and using short-acting bronchodilators more than once a week were enrolled in a double-blind, double dummy, randomised, multicentric study. After a two week run-in period on nebulised twice daily 400 mcg beclomethasone dipropionate, patients were randomly assigned to twelve weeks of treatment with 800 mcg nebulised beclomethasone dipropionate daily, either in single dose (o.d. group) or divided into two 400 mcg doses (b.i.d. group). RESULTS: 65 children (mean age 8.6 years, mean FEV1 81% of predicted), were valuable for intention to treat. During the run-in period, a significant improvement in FEV1, FVC, morning and evening PEF values and clinical scores was observed. Children then entered the randomised trial: 32 were included in the o.d. group and 33 in the b.i.d. group. During the twelve week treatment period, the observed improvement in pulmonary function parameters was maintained in both treatment groups. Morning and evening PEF showed a progressive slight increase as well as PEF diurnal variability showed a progressive reduction in the two treatment groups during the whole study period without reaching statistical significance. Moreover, in both treatment groups a similar progressive increase in symptom free nights and days and in the percentage of children achieving total asthma symptoms control was detected. Finally, no significant changes in urinary cortisol/creatinine ratio were observed throughout the study period and between groups. CONCLUSIONS: A daily dose of 800 mcg of beclomethasone, administered for twelve weeks with a nebuliser either once or twice daily provide similar efficacy in maintaining pulmonary function and symptoms of asthmatic children, with a good tolerability profile.


Subject(s)
Anti-Asthmatic Agents/administration & dosage , Asthma/drug therapy , Asthma/physiopathology , Beclomethasone/administration & dosage , Forced Expiratory Volume/drug effects , Nebulizers and Vaporizers , Peak Expiratory Flow Rate/drug effects , Vital Capacity/drug effects , Anti-Asthmatic Agents/adverse effects , Anti-Asthmatic Agents/metabolism , Beclomethasone/adverse effects , Beclomethasone/metabolism , Child , Child, Preschool , Circadian Rhythm/drug effects , Creatinine/urine , Double-Blind Method , Female , Humans , Hydrocortisone/urine , Male , Patient Compliance , Spirometry , Treatment Outcome
9.
Int J Pharm ; 510(1): 263-70, 2016 Aug 20.
Article in English | MEDLINE | ID: mdl-27326484

ABSTRACT

In this study, novel polymeric nanoparticles (NPs) were developed and their potential as carriers for beclomethasone dipropionate (BDP) into the lung after aerosolization was demonstrated by in vivo studies in mice. In particular, these NPs were obtained starting from two polyaspartamide-based copolymers which were synthesized by chemical reaction of α,ß-poly(N-2-hydroxyethyl)-dl-aspartamide (PHEA) and its pegylated derivative (PHEA-PEG2000) with poly(lactic acid) (PLA). To obtain nanosized particles, the high pressure homogenization (HPH)-solvent evaporation method was followed by using an organic phase containing both PHEA-PLA and PHEA-PEG2000-PLA (at a weight ratio equal to 1:1), lactose as cryoprotectant and no surfactant was adopted. PHEA-PLA/PHEA-PEG2000-PLA NPs were characterized by a quite spherical shape, ζ potential slightly negative, and size lower than 50 and 200nm, respectively, for empty and BDP-loaded NPs. In vivo biodistribution of BDP and its metabolites in various lung compartments, i.e. bronchoalveolar lavage fluid (BALF), alveolar macrophages (MPG) obtained from BALF, and lung tissue, was carried out at 3h post-administration in mice by aerosolization of BDP-loaded NPs or free BDP (commercial formulation, Clenil(®)) at the dose of 0.5mg/kg BDP. Results demonstrated that BDP entrapped into NPs reached all analyzed lung compartments and were internalized by both alveolar MPG and respiratory epithelial cells, and detected amounts were comparable to those of Clenil-treated mice. Moreover, the entrapment into NPs protects the drug from the enzymatic hydrolysis, allowing a significant lower amount of beclomethasone (BOH) into the lung tissue and BALF than that obtained after Clenil administration.


Subject(s)
Glucocorticoids/metabolism , Lung/metabolism , Nanoparticles/metabolism , Peptides/metabolism , Administration, Inhalation , Aerosols , Animals , Beclomethasone/administration & dosage , Beclomethasone/metabolism , Bronchoalveolar Lavage Fluid , Drug Evaluation, Preclinical/methods , Glucocorticoids/administration & dosage , Lung/drug effects , Mice , Nanoparticles/administration & dosage , Peptides/administration & dosage , Tissue Distribution/drug effects , Tissue Distribution/physiology
10.
J Aerosol Med Pulm Drug Deliv ; 29(2): 127-33, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26061801

ABSTRACT

BACKGROUND: The asthmatic patient's respiratory tract deposition of HFA fluticasone (Flovent HFA(™)) has not been established. There is a known large particle size difference with another commercial inhaled HFA steroid (QVAR(™)). This study compared the 2D and 3D respiratory tract deposition of each inhaled steroid. METHODS: This study was an open label, crossover study in eight patients diagnosed with asthma. The regional respiratory and oropharyngeal deposition of the two steroids were compared and contrasted using planar and SPECT imaging following delivery of the (99m)Tc-radiolabeled drug in each product. The SPECT images were merged with computed tomography images to quantify regional deposition within the patients. RESULTS: Two-dimensional (2D) planar images indicated that 24% of the Flovent HFA dose and 55% of the QVAR dose deposited in the lungs. 2D oropharyngeal deposition indicated that 75% of the Flovent HFA dose was deposited in the oropharynx, while 42% of the QVAR dose deposited in the oropharynx. Three-dimensional (3D) SPECT data indicated that 22% of the Flovent HFA dose and 53% of the QVAR dose deposited in the lungs. 3D oropharyngeal and gut deposition indicated 78% of the Flovent HFA dose was deposited in the oropharynx, while 47% of the QVAR dose deposited in the oropharynx. The increased lung deposition and decreased oropharynx deposition for both 2D and 3D image data of QVAR were statistically different from Flovent HFA. CONCLUSIONS: QVAR exhibited a significant increase in lung delivery compared to Flovent HFA. Conversely, QVAR delivered a significantly lower dose to the oropharynx than Flovent HFA. The findings were presumed to be driven by the smaller particle size of QVAR (0.7 microns MMAD) compared with Flovent HFA (2.0 microns MMAD).


Subject(s)
Anti-Asthmatic Agents/metabolism , Asthma/drug therapy , Beclomethasone/metabolism , Bronchodilator Agents/metabolism , Fluticasone/metabolism , Lung/metabolism , Administration, Inhalation , Adult , Aerosol Propellants/chemistry , Aerosols , Anti-Asthmatic Agents/administration & dosage , Anti-Asthmatic Agents/chemistry , Asthma/diagnostic imaging , Asthma/metabolism , Beclomethasone/administration & dosage , Beclomethasone/chemistry , Bronchodilator Agents/administration & dosage , Bronchodilator Agents/chemistry , Cross-Over Studies , Drug Compounding , Fluticasone/administration & dosage , Fluticasone/chemistry , Humans , Hydrocarbons, Fluorinated/chemistry , Lung/diagnostic imaging , Male , Metered Dose Inhalers , Middle Aged , Multimodal Imaging/methods , Oropharynx/metabolism , Particle Size , Radiographic Image Interpretation, Computer-Assisted , Tomography, Emission-Computed, Single-Photon , Tomography, X-Ray Computed , Young Adult
11.
Drugs ; 28(2): 99-126, 1984 Aug.
Article in English | MEDLINE | ID: mdl-6381025

ABSTRACT

Inhaled beclomethasone dipropionate is now well established in the management of asthma. Studies conducted over the last decade, and since the drug was previously reviewed in the Journal, have confirmed that inhaled beclomethasone dipropionate 400 to 800 micrograms daily can reduce the need for oral maintenance corticosteroids in the majority of asthmatic patients requiring such therapy, and that increasing the dosage to 2000 micrograms daily may provide additional clinical benefit in some patients unresponsive to usual therapeutic dosages. Follow-up over a period of several years has confirmed that the initial response to inhaled beclomethasone can be maintained in most patients. Recent studies indicate that beclomethasone dipropionate 400 micrograms daily is equally effective when administered in 2 or 4 divided doses in patients with stable asthma, but it is likely that the lower frequency of administration will be less effective when the asthma is unstable. Recent studies have established the usefulness and good tolerability of intranasal beclomethasone dipropionate in the treatment of perennial and seasonal rhinitis, where the drug has been shown to be more effective than intranasal sodium cromoglycate and similar in efficacy to flunisolide. Nasal polyps decrease in size during continuous treatment with intranasal beclomethasone dipropionate, but enlarge again during periods of respiratory infection. After a decade of treatment with inhaled and intranasal beclomethasone dipropionate, there is no evidence that the drug damages the tracheobronchial lining or the nasal mucosa. Thus, the initial promise of beclomethasone dipropionate has been fulfilled. It has had an important role in asthma therapy over the past decade, which will continue into the future.


Subject(s)
Asthma/drug therapy , Beclomethasone/therapeutic use , Rhinitis/drug therapy , Adrenal Glands/drug effects , Aerosols , Beclomethasone/administration & dosage , Beclomethasone/adverse effects , Beclomethasone/metabolism , Bronchi/drug effects , Drug Therapy, Combination , Glucocorticoids/pharmacology , Humans , Immunity/drug effects , Kinetics , Nasal Mucosa/drug effects
12.
Drugs ; 10(3): 166-210, 1975.
Article in English | MEDLINE | ID: mdl-172309

ABSTRACT

Beclomethasone dipropionate is a topically active corticosteroid used as an adjuvant in the control of chronic asthma when given by inhalation as an aerosol. It is not intended for treatment of acute attacks. It appears that the main difference between beclomethasone dipropionate and other corticosteroids previously used by inhalation is its high topical activity together with a lower systemic activity due to metabolic inactivation of the swallowed portion of the dose. Clinical experience has shown that at doses of 200 to 600mug daily, beclomethasone dipropionate inhaler is preferable to oral corticosteroids, because of lack of side-effects, when adult patients and children who are inadequately controlled by full doses of sodium cromoglycate and bronchodilators, are first considered to need maintenance corticosteroids. Inhaled beclomethasone dipropionate can allow a worthwhile reduction in maintenance doses of systemic corticosteroids in many patients already receiving these drugs and can replace systemic steroids entirely in some patients, particularly when their initial dose of steroids is less than 10mg daily of prednisone or its equivalent. Substitution should be attempted when the patient's asthma is well controlled on their usual doses of systemic steroids and full doses of other adjuvant therapy. Withdrawal of systemic corticosteroids should be performed slowly and carefully. Because recovery from impaired adrenocortical function caused by prolonged systemic steroid therapy is usually slow, special care is necessary for 9 to 12 months after transfer to beclomethasone dipropionate aerosol until the hypothalamo-pituitary-adrenal axis has sufficiently recovered to cope with emergencies such as trauma, surgery, severe infections or an acute attack of asthma. It is essential that additional therapy including high doses of systemic corticosteroids be used immediately to control any acute exacerbation of asthma which occurs during maintenance therapy with beclomethasone dipropionate aerosol. Tests of adrenal function suggest that beclomethasone dipropionate at dosages of 400 to 800 mug daily has little or no adverse effect. The most common side-effect associated with the continuous use of beclomethasone dipropionate inhaler has been oropharyngeal candidiasis, which appears to be dose-related and more common in women than in men. Systemic steroid withdrawal effects, like being generally unwell, and exacerbation of underlying allergic diseases such as allergic rhinitis, have been reported after substitution of beclomethasone dipropionate inhaler for systemic steroids. However, systemic withdrawal effects seldom occur if systemic steroids are withdrawn slowly.


Subject(s)
Asthma/drug therapy , Beclomethasone/therapeutic use , Methylprednisolone/analogs & derivatives , 17-Ketosteroids/urine , Administration, Oral , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/therapeutic use , Adrenocorticotropic Hormone/pharmacology , Adult , Aerosols , Beclomethasone/administration & dosage , Beclomethasone/adverse effects , Beclomethasone/metabolism , Beclomethasone/pharmacology , Child , Clinical Trials as Topic , Drug Evaluation , Forced Expiratory Volume , Half-Life , Humans , Hydrocortisone/blood , Kinetics , Middle Aged , Substance-Related Disorders
13.
J Psychiatr Res ; 37(3): 221-8, 2003.
Article in English | MEDLINE | ID: mdl-12650741

ABSTRACT

It has been hypothesized that patients with posttraumatic stress disorder (PTSD) show increased glucocorticoid sensitivity. The study tested beclomethasone-induced vasoconstriction (BIV), a measure of peripheral glucocorticoid sensitivity, in women with PTSD. A case-control design was employed in 33 PTSD patients and 33 healthy controls. BIV was tested using beclomethasone dipropionate (1-100 micro g/ml). Vasoconstriction was assessed after 15-18 h. Waking and afternoon salivary cortisol concentrations were measured. BIV ratings were significantly increased in PTSD at beclomethasone concentrations from 10-100 micro g/ml. Salivary cortisol concentrations did not differ between groups or correlate with BIV. Preliminary evidence has been found for increased peripheral glucocorticoid sensitivity in PTSD. Further study is required to replicate this finding and assess its relationship to the pathophysiology of the disorder.


Subject(s)
Beclomethasone/adverse effects , Beclomethasone/metabolism , Drug Hypersensitivity/etiology , Glucocorticoids/adverse effects , Glucocorticoids/metabolism , Stress Disorders, Post-Traumatic/metabolism , Vasoconstriction/drug effects , Adolescent , Adult , Aged , Female , Humans , Hydrocortisone/analysis , Hydrocortisone/metabolism , Middle Aged , Saliva/chemistry , Severity of Illness Index , Stress Disorders, Post-Traumatic/diagnosis
14.
Pharmacotherapy ; 4(6): 334-42, 1984.
Article in English | MEDLINE | ID: mdl-6393075

ABSTRACT

Since the 1950s, corticosteroid aerosols have proved useful in the treatment of asthma. Although their precise mechanism of action is not known, these topical agents have beneficial antiinflammatory and decongestive effects on the bronchial tree in both the allergic and nonallergic forms of this disease. Four of the newer aerosolized steroids--beclomethasone dipropionate, triamcinolone acetonide, flunisolide and budesonide--have been evaluated in clinical trials. The last drug is still investigational. Their side effects are minimal, the major ones being oral candidiasis and dysphonia. They are most effective when used prophylactically and should not be administered during acute asthmatic attacks, as insufficient amounts of drug are inhaled when the airways are obstructed. Patients must be instructed in the correct techniques of administering steroid aerosols to ensure optimal therapy.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , Asthma/drug therapy , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/adverse effects , Adrenal Cortex Hormones/metabolism , Aerosols , Beclomethasone/adverse effects , Beclomethasone/metabolism , Beclomethasone/therapeutic use , Budesonide , Chemical Phenomena , Chemistry , Fluocinolone Acetonide/analogs & derivatives , Fluocinolone Acetonide/metabolism , Fluocinolone Acetonide/therapeutic use , Humans , Kinetics , Pregnenediones/metabolism , Pregnenediones/therapeutic use , Structure-Activity Relationship , Triamcinolone Acetonide/metabolism , Triamcinolone Acetonide/therapeutic use
15.
Chem Biol Interact ; 66(1-2): 13-25, 1988.
Article in English | MEDLINE | ID: mdl-3383285

ABSTRACT

A method for the quantitative assessment of steroidal esterase activity in viable human mononuclear leukocytes (HML) has been developed. It is based on estimating the conversion of [3H]beclomethasone-17,21-dipropionate (BDP) to beclomethasone-17-monopropionate (BMP) using TLC on silica gel 60 F-254 plates developed in a solvent system of chloroform/methanol (97:3, v/v). The cell assay procedure was dependent on BDP concentration, incubation time and cell concentration. The steroidal esterase activity was completed for by N-acetoxy-N-acetyl-2-aminofluorene (NA-AAF) and completely inhibited by 100 microM paraoxon. When [3H]NA-AAF binding to DNA was used as an indicator of HML esterase (deacylase) activity, BDP functioned as a substrate inhibitor. Parallel estimations of BDP metabolism and NA-AAF binding to DNA indicated striking correlations in the interindividual variations (r = 0.62, P less than 0.001) and in relation to the menstrual cycle events of a healthy female. Hence, these data indicate that both BDP and NA-AAF are metabolized by the same non-specific steroidal esterase present in HML.


Subject(s)
2-Acetylaminofluorene/analogs & derivatives , Acetoxyacetylaminofluorene/metabolism , Carboxylic Ester Hydrolases/blood , DNA/metabolism , Leukocytes, Mononuclear/enzymology , Sterol Esterase/blood , Beclomethasone/metabolism , Female , Hot Temperature , Humans , Kinetics , Menstrual Cycle , Paraoxon/pharmacology
16.
J Pharm Sci ; 67(10): 1428-31, 1978 Oct.
Article in English | MEDLINE | ID: mdl-702295

ABSTRACT

A simulated respiratory system was developed for the in vitro evaluation of two differently designed oral inhalation delivery systems. The deposition properties of a newly designed delivery system used for triamcinolone acetonide were compared to the more conventional, commercially available adapter utilized for an aerosol containing beclomethasone dipropionate. The simulated respiratory system was constructed so that the delivered dose of active ingredient could be classified into two fractions: the fraction that would be deposited in the oral cavity and throat and the fraction that would reach the desired site of activity in the respiratory tract. Based on this method, the newly designed system delivered more than 95% of the labeled dose to the desired site. The beclomethasone dipropionate aerosol system, which was observed to discharge the active ingredient with a greater intensity, delivered approximately 40% of the labeled dose. The particle-size distribution of the dose dispensed from the newly designed delivery system attached to the triamcinolone acetonide aerosol was determined using an impactor technique. No effort was made to correlate these results with an in vivo response.


Subject(s)
Aerosols , Drug Packaging , Glucocorticoids/metabolism , Respiratory System/metabolism , Beclomethasone/administration & dosage , Beclomethasone/metabolism , Glucocorticoids/administration & dosage , Solutions , Suspensions , Triamcinolone Acetonide/administration & dosage , Triamcinolone Acetonide/metabolism
17.
J Pharm Sci ; 89(9): 1143-50, 2000 Sep.
Article in English | MEDLINE | ID: mdl-10944379

ABSTRACT

The systemic availability of inhaled beclomethasone dipropionate (BDP) is the net result of the absorption of the glucocorticoid from the lower respiratory and gastrointestinal tracts, and metabolism in the lung, plasma, and other sites. The metabolism kinetics of BDP and its active metabolite, beclomethasone 17-monopropionate (17-BMP), in human lung 1000 x g supernatant (HLu) and human plasma (HP) at 37 degrees C were compared. The effect of MgCl(2) and/or an NADPH-generating system on the decomposition of BDP and 17-BMP in HLu was also investigated. The concentrations of BDP and its metabolites were determined by HPLC with UV detection at 242 nm. Kinetics of decomposition of BDP and 17-BMP in HLu and HP were qualitatively and quantitatively different. The decomposition of BDP in HLu involved only hydrolysis. In comparison, three reactions are involved following incubation of BDP in HP; namely, hydrolysis, transesterification, and loss of hydrogen chloride. The hydrolysis of BDP and 17-BMP in HLu seem to be inhibited appreciably by MgCl(2) with the NADPH-generating system. Effective activation of BDP in HLu, in combination with transesterification of 17-BMP in HP, might favor a high ratio of local antiinflammatory activity to systemic side effects following inhalation of BDP.


Subject(s)
Anti-Asthmatic Agents/metabolism , Beclomethasone/analogs & derivatives , Beclomethasone/metabolism , Glucocorticoids/metabolism , Lung/metabolism , Adolescent , Aged , Aged, 80 and over , Anti-Asthmatic Agents/blood , Anti-Asthmatic Agents/pharmacokinetics , Beclomethasone/blood , Beclomethasone/pharmacokinetics , Biotransformation , Culture Techniques , Female , Glucocorticoids/blood , Glucocorticoids/pharmacokinetics , Humans , Magnesium Chloride/pharmacology , Male , Middle Aged , NADP/metabolism , NADP/pharmacology
18.
J Pharm Biomed Anal ; 14(7): 793-800, 1996 May.
Article in English | MEDLINE | ID: mdl-8809703

ABSTRACT

Four commercially available beclomethasone metered dose inhalers were analyzed for both spray content uniformity and particle size. The drug contents of primed and unprimed sprays collected at the beginning of the lifetime of the canister were not significantly different from those collected throughout the experiment. Particle size analysis of the four products using the Andersen Cascade Impactor Mark II showed that the distribution profiles were not identical. An existing HPLC method was modified to quantitate single sprays for content uniformity and to measure the amount on an impactor stage for particle sizing.


Subject(s)
Anti-Inflammatory Agents/metabolism , Beclomethasone/metabolism , Nebulizers and Vaporizers/standards , Administration, Inhalation , Aerosols/analysis , Aerosols/standards , Analysis of Variance , Anti-Inflammatory Agents/administration & dosage , Beclomethasone/administration & dosage , Chromatography, High Pressure Liquid , Particle Size
19.
J Pharm Pharmacol ; 36(11): 763-5, 1984 Nov.
Article in English | MEDLINE | ID: mdl-6150981

ABSTRACT

Tritiated budesonide and beclomethasone 17 alpha,21-dipropionate (BDP) were incubated with the 9000g supernatant of human liver homogenate. BDP was immediately hydrolysed to beclomethasone 17 alpha-propionate (BMP). BMP was then further biotransformed to polar metabolites. Budesonide was rapidly biotransformed (2-4 times more rapidly than BMP) to metabolites of low glucocorticoid potency. The compounds were also incubated with the 1000g supernatant of human lung homogenate. BDP was rapidly hydrolysed to BMP and then more slowly to beclomethasone. Budesonide was not biotransformed in the lung.


Subject(s)
Anti-Inflammatory Agents/metabolism , Beclomethasone/metabolism , Liver/metabolism , Lung/metabolism , Pregnenediones/metabolism , Administration, Topical , Biotransformation , Budesonide , Glucocorticoids , Humans , In Vitro Techniques , Time Factors
20.
J Pharm Pharmacol ; 37(8): 532-5, 1985 Aug.
Article in English | MEDLINE | ID: mdl-2864411

ABSTRACT

Inclusion complex formation of beclomethasone dipropionate (BMDP) with gamma-cyclodextrin (gamma-CyD) in water and in solid state was assessed by solubility analysis and X-ray diffractometry. The solid complex of BMDP with gamma-CyD in a molar ratio of 1:2 was prepared and its in-vitro release behaviour was investigated using an ointment release simulator. The release of BMDP from hydrophilic ointment was significantly improved by the gamma-CyD complexation. Permeation and uptake studies indicated that the enhanced release of BMDP from the ointment may be due to the faster dissolution and the lower binding affinity of the complex in the ointment base. The vasoconstrictor activity of BMDP in man was found to be increased by gamma-CyD complexation, suggesting an improvement in the percutaneous absorption of BMDP.


Subject(s)
Beclomethasone/metabolism , Cyclodextrins/pharmacology , Dextrins/pharmacology , Skin Absorption/drug effects , Starch/pharmacology , gamma-Cyclodextrins , Chemistry, Pharmaceutical , Humans , Male , Membranes/metabolism , Ointments , Permeability , Solubility , Time Factors , Vasoconstriction/drug effects
SELECTION OF CITATIONS
SEARCH DETAIL