Beclomethasone dipropionate for asthma let us discuss about beclomythasone. What is this drug, beclomythasone? This is one of the topical corticosteroids given as inhal corticosteroids. This beclomythasone is given in the form of dipropionate, which is used in the treatment as well as prophylaxis of asthma, both in the children as well as in the adults. But within the children, it should be given with age greater than five years in order to reduce the recurrence of asthmatic attacks.
And this beclomyxone can also be combined with bronchodilators. Particularly, it can be combined with levosol butamol. And this combination can also be given as aerosol in the treatment of the asthma. So beclomethone can be given either alone or in combination. And this drug is available as MDI, Metadose Inhaler, or it is also available as DPI, dry powder inhalation, where this drug is available as a dry powder, which is going to be directly inhaled into the lungs. So today in this video, we are going to see how this drug acts, what are the important precautions, side effects, doses, all these things we will discuss in this video. First of all, let us the precautions of beclomyxone.
One of the important precaution of beclomethone is that this drug can inhibit the T cell activity. T cell activity is going to be inhibited by beclomyxone, so this drug can produce some immunosuppression. When the immunity is going to be suppressed, it can increase the risk of infection. So bacterial, viral, and fungal infections can be increased. So this drug should be carefully given in the patients with any risk of tuberculosis or any viral infections like Varsel or Jostel infections.
And on long term use, beclomethone can increase the risk of these infections. Similarly, this drug, when it is given as aerosol, it can be sprayed into the mouth, which produce the local deposition of this drug within the esophagus. Since this drug acts as immunosuppresent, it can reduce the T cell activity at the local area. So when the T cell activity is going to be reduced, it can increase the risk of fungal infections. So beclinonexone can produce some local fungal infections. Particularly candida albicans can be increased, which can produce some condition, oral thrash. So this is a fungal infection produced by local deposition of beclomyxone, which produce some redness, burning sensation, loss of taste, even difficulty in swallowing.
All these symptoms can be observed because of oral thrash, or it is also called as oropharyngeal candidiasis. So in order to avoid this fungal infection, when this beclomyxone is going to be used immediately, the mouth should be rinsed with water so that we can remove any local deposition of this drug. Similarly, beclomethone can affect the eye and it can produce some visual disturbances. This is particularly more important in the patients with any risk of glaucoma and cataracts as this drug can increase the risk of cataracts and glaucoma. So in such patients, this drug should be carefully given.
And this drug can also reduce the bone mineral density, which may increase the risk of osteoporosis. Similarly, beclomethone can reduce the growth in the children, and it can also reduce the adenalic axis, resulting in the adenalic septition. So this is a common side effect observed with many of the corticosteroids. Since beclomethone is used both in the children as well as adults, within the children, it can reduce the growth on increased dose and frequency of administration. And it can also suppress the HP axis, which may develop the symptoms of Cushing syndrome. So on long term treatment, this beclone is shown to be carefully used at low dose in order to avoid internal separation and retardation of the growth in the children.
Now, let us see the side effects of this drug. The important side effects of this drug are mainly local reactions. It can produce some headache, pharyngitis, sinusitis, rhinitis. It can also produce some back pain, nausea. And because of increased local deposition at the oropharynx, it can produce some oropharyngeal candidiasis. And finally, this treat can also affect the vision, resulting in the blood vision. These are the common side effects produced by beclomyxone. Now, let us see how this treat acts. Beclomyxone is one of the steroids.
It can act on the nuclear receptors. So glucocortica receptors are located within the cytoplasm, which are associated with one of the protein HSP90. Now, they target the DNA within the nucleus. When beclomyxone binds to glucocort cut receptor, it is going to be internalized, where it is going to be dimerized. This dimerized glucocort cut receptor can activate the DNA, resulting in the gene transcription and production of mRNA. This mRNA codes for proteins in Cis so that it can release few of the proteins such as lipocortin 1 and NXA1. These are the antiinflammatory mediators which can reduce the inflammatory cascade. Similarly, beclomethone can also reduce the expression of IL2.
So IL2 production and proliferation of T cell activity is going to be reduced by beclomethone. Similarly, if you have the inflammatory mediators, can act on their corresponding receptor so that they can activate one of the pathway NFKB, nuclear factor KappaB. This factor can also interact with the DNA, resulting in the gene transcription, leading to release of so many inflammatory mediators. Now, again, beclomytazone can reduce this NFKB pathway such that the release of inflammatory mediators is going to be inhibited.
Beclomethone can also act on the COX pathway. So any inflammatory stimuli can stimulate one of the enzyme, Phospholipaz eA2. This Phospholipaz eA2 can cle the Phospholipids such that they are going to be converted into one of the important mediator, arachnoidic acid. This arachnoidic acid can be converted to various mediators by one of the enzyme, Cox Enzyme. By action of this enzyme, arachnoidic acid can be converted into various mediators such as PGE2, PGI2, and thromboxan A2.
All these mediators can produce inflammation, pain, and swelling, which is going to be reduced by beclomethone. Now, beclomethone can stimulate one of the factor, Nxin A1, which is going to inhibit the fosfolipase A2 pathway. When this pathway is inhibited, the release of inflammatory mediators are going to be inhibited.
Similarly, beclomethone can also inhibit the COX pathway. By all of these actions, it can reduce the inflammatory cascade. That’s why beclomethone acts as anti inflammation agent. How it is given? This drug is available as metadose inhal as well as dry powder inhaler. It is available at different strengths such as 40 micrograms and 80 micrograms. In the adults with S greater than 12 years, this drug is given at an initial dose in between 40 to 80 micrograms, given twice daily. The dose can be slowly escalated based on the response, but the maximum dose is 320 micrograms, given twice daily.
But in the pediatric patients with SIS 5 to 11 years, the initial dose is around 40 micrograms, given twice daily. And the maximum dose is 80 micrograms, twice daily. So that’s about this drug Baclomethone, which is an inhal corticosteroid, which is used as a prophylactic in the management of asthma. Since this drug acts as an antiinflammatory agent, this drug can reduce the recurrence of asthmatic attacks, and this drug can be given in the children with age greater than five years. Baclomethone can also be combined with bronchodilators such as Salbutamol. This drug mainly produce local fungal reactions, resulting in the overall thrash, which can be prevented by washing the mouth after every use of beclomythone.
