Budesonida inalatória em crianças com asma aguda

Abstract

Objective: To investigate the efficacy of a single dose of inhaled budesonide as compared to oral prednisone in patients with acute asthma.Methods: Randomized double-blind, double-dummy and placebo-controlled clinical trial. Fortynine children aged 2 to 7 years with acute asthma were randomized in three groups after receiving nebulized salbutamol (0.15 mg/kg). Group I received placebo both as tablets and nebulization, group II was treated with a single dose of oral prednisone (1 mg/kg) and inhaled placebo, and group III received a single dose of placebo tablet and nebulized budesonide (2 mg). Patients were evaluated in terms of symptom score and transcutaneous hemoglobin saturation. Nebulized salbutamol was repeated in case of increasing symptom score or lower saturation.Results: Progressive clinical improvement was observed in all three groups. However, a significant increase in hemoglobin saturation was observed after 2 hours with prednisone, 4 hours with budesonide, and 24 hours with placebo. Conclusion:A combination of single-dose nebulized budesonide and salbutamol may be as effective as oral prednisone to improve symptom severity, but the latter increases hemoglobin saturation in exacerbation of asthma.J Pediatr (Rio J). 2004;80(2):106-12: Budesonide, acute asthma, prednisone, inhaled steroids.

Asma: efeitos orgânicos no desenvolvimento infantil

“…Os efeitos locais, geralmente são rouquidão, pigarro e monilíase oral.Relacionando os efeitos colaterais com o artigo que cita o uso de budesonida inalatória e prednisona em crianças com asma aguda, verifica-se nos dois últimos parágrafos dos resultados que uma quantidade bem pequena apresentou vômitos após a administração de prednisona oral e persistência de tosse aos que utilizaram inalação com budesonida. Vale ressaltar que a quantidade manifestada é pequena, ou seja, em geral as medicações foram bem toleradas e eficazes12 .…”

Inhaled budesonide for acute asthma - is it all a question of time and space?

“…Nesse caminho, e escolhendo como pergunta: Há diferença na eficácia da prednisona oral em relação à budesonida inalatória no tratamento da crise asmática?, Milani et al planejaram um ensaio clínico intitulado Budesonida inalatória em crianças com asma aguda, que é de grande relevância para a prática diária, pois mimetiza aquela recomendação de usar esteróide nos episódios agudos moderados quando existe resposta incompleta ou recaída de sintomas após a utilização de ß2-agonista inalatório 5 .…”

Budesonida inalatória em asma aguda: uma questão de tempo e espaço?

“…Milani et al planned a clinical trial entitled Nebulized budesonide to treat acute asthma in children which is of great relevance for daily practice since it incorporates the recommendation of steroids for moderate acute episodes when there is an incomplete response or a recurrence of symptoms after inhaled b2-agonist has been used. 5 The study design employing double-placebo made three comparison groups possible: the conduct to be tested (inhaled budesonide), standard conduct (oral corticoids) and no steroid treatment (double-placebo group). Ethically, the real need for this last group could be questioned, since oral prednisone is well established for acute asthma, but the most important point is that severe asthmatics were excluded.…”