Inhaled corticosteroids: potency, dose equivalence and therapeutic indexGlucocorticosteroids are a group of structurally related molecules that includes comparing potency of inhaled corticosteroids hormones and synthetic drugs with a wide range of anti-inflammatory potencies. For synthetic corticosteroid analogues it is commonly assumed that the therapeutic index cannot be improved by increasing their glucocorticoid receptor binding affinity. The validity of this assumption, particularly for inhaled corticosteroids, has not been fully explored. Inhaled corticosteroids exert their anti-inflammatory activity locally in the airways, and hence this can be dissociated from their potential to comparing potency of inhaled corticosteroids systemic adverse effects. The molecular structural features that increase glucocorticoid receptor binding affinity and selectivity drive topical anti-inflammatory activity. However, in addition, these structural modifications also result in physicochemical and pharmacokinetic pro anabolic fast grow powder that can enhance targeting to the airways and reduce systemic exposure.
inhaled steroids (comparison of equivalent doses) - General Practice Notebook
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