Which medications in the drug class Inhaled long-acting bronchodilator/corticosteroid combinations are used in the treatment of Mold Allergy?

Updated: Dec 02, 2020
  • Author: Shih-Wen Huang, MD; Chief Editor: Harumi Jyonouchi, MD  more...
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Inhaled long-acting bronchodilator/corticosteroid combinations

One of the advantages of long-acting beta-agonists is prolonged relief for patients with obstructive lung disease (eg, asthma). They are especially useful for patients with nocturnal cough. However, long-acting beta(2)-adrenergic agonists including salmeterol and formoterol have a black box warning regarding an increase in risk of asthma-related deaths. Because of this risk, salmeterol use is contraindicated without a concomitant long-term asthma control medication such as an inhaled corticosteroid. To ensure compliance with therapy, a fixed-dose combination product containing both an inhaled corticosteroid and LABA is recommended in pediatric and adolescent patients. [30]

Salmeterol/fluticasone inhaled (Advair)

Fluticasone inhibits bronchoconstriction mechanisms, produces direct smooth muscle relaxation, and may decrease the number and activity of inflammatory cells, in turn decreasing airway hyper-responsiveness. It also has vasoconstrictive activity.

Salmeterol relaxes the smooth muscles of the bronchioles in conditions associated with bronchitis, emphysema, asthma, or bronchiectasis, and can relieve bronchospasms. Effects may also facilitate expectoration.

Adverse effects are more likely to occur when administered at high or more frequent doses than recommended. Two delivery mechanisms are available (ie, powder for inhalation [Diskus], metered-dose inhaler [MDI]). Diskus is available as a combination of salmeterol 50-mcg with fluticasone 100 mcg, 250 mcg, or 500 mcg. MDI is available as 21 mcg salmeterol with fluticasone 45 mcg, 115 mcg, or 230 mcg.

Budesonide/formoterol (Symbicort)

Formoterol relieves bronchospasm by relaxing the smooth muscles of the bronchioles in conditions associated with asthma.

Budesonide is an inhaled corticosteroid that alters level of inflammation in airways by inhibiting multiple types of inflammatory cells and decreasing production of cytokines and other mediators involved in the asthmatic response.

It is available as an MDI in 2 strengths; each actuation delivers formoterol 4.5 mcg with either 80 or 160-mcg of budesonide

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