What is the role of inhaled corticosteroids in the treatment of acute asthma?

Updated: Nov 20, 2020
  • Author: Michael J Morris, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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The mainstay of ED therapy for acute asthma is inhaled beta2 agonists. The most effective particle sizes are 1-5 μm. Larger particles are ineffective because they are deposited in the mouth and central airways. Particles smaller than 1 μm are too small to be effective because they move in the airways by Brownian motion and do not reach the lower airways.

Although studies in patients with COPD reported increased rates of pneumonia associated with inhaled corticosteroid use, a study by O’Byrne et al found no increased risk in patients with asthma in clinical trials using budesonide. [97]

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