Medication Card Pulmicort (Budesonide) / 풀미코트 (부데소니드) (Kor/Eng)

Classification (분류)

• English: Corticosteroid (inhaled), anti-inflammatory, glucocorticoid
• Korean: 흡입용 코르티코스테로이드, 항염증제, 글루코코르티코이드

 

 

 

 

 

Indications (적응증)

• English:
  • Maintenance treatment of asthma
  • Chronic obstructive pulmonary disease (COPD)
  • Allergic rhinitis (nasal spray form)
• Korean:
  • 천식의 유지 치료
  • 만성 폐쇄성 폐질환 (COPD)
  • 알레르기 비염 (비강 분무제 형태)

 

 

 

 

 

 

 

Therapeutic Effects (치료 효과)

• English: Decreases airway inflammation, reduces asthma symptoms, prevents exacerbations
• Korean: 기도 염증 감소, 천식 증상 완화, 악화 예방

 

 

 

 

 

 

 

Absorption (흡수)

• English: Systemic absorption after inhalation is ~39%
• Korean: 흡입 후 약 39% 전신 흡수

 

 

 

 

 

 

 

 

Distribution (분포)

• English: Widely distributed to lungs and airway tissue
• Korean: 폐 및 기도 조직에 광범위하게 분포

 

 

 

 

 

 

Protein Binding (단백 결합)

• English: 85–90% bound to plasma proteins
• Korean: 약 85–90% 혈장 단백 결합

 

 

 

 

 

 

 

Metabolism & Excretion (대사 및 배설)

• English: Metabolized in the liver (CYP3A4); excreted mainly in urine
• Korean: 간(CYP3A4)에서 대사, 주로 소변으로 배설

 

 

 

 

 

 

 

Adverse Effects (부작용)

Common (흔한 부작용):

• Oral thrush (구강 칸디다증)
• Hoarseness (쉰 목소리)
• Cough, throat irritation (기침, 인후 자극)

Less common but serious (심각한 부작용):

• Adrenal suppression (부신 억제)
• Growth retardation in children (소아 성장 지연)
• Increased risk of infection (감염 위험 증가)

 

 

 

 

 

 

 

 

Dosage (투여 용량)

• Adults (성인): Inhalation 180–720 mcg twice daily (depending on severity)
• Children (소아): 180–360 mcg twice daily

 

 

 

 

 

 

Nursing Considerations (간호 시 고려사항)

• Assess respiratory status (lung sounds, peak flow, symptom relief)
• Monitor for signs of oral candidiasis → encourage mouth rinsing after use
• Do not use for acute asthma attack (not a rescue medication)
• Monitor growth in pediatric patients with long-term use
• May take 1–2 weeks for full therapeutic effect

 

 

 

 

 

 

 

Patient Teaching (환자 교육)

English:

• Use every day as prescribed, even if you feel better.
• Not for sudden asthma attacks; always keep a rescue inhaler (e.g., albuterol).
• Rinse mouth with water after each use to prevent thrush.
• Report persistent sore throat, white patches in mouth, or difficulty breathing.
• Do not stop suddenly; taper if long-term therapy is discontinued.

Korean (한국어):

• 증상이 좋아져도 의사가 지시한 대로 매일 사용하세요.
• 급성 천식 발작에는 사용하지 말고, 항상 구급 흡입기(예: 알부테롤)를 소지하세요.
• 사용 후에는 구강 칸디다증 예방을 위해 반드시 물로 입을 헹구세요.
• 목통증, 구강 내 흰 반점, 호흡 곤란이 지속되면 즉시 보고하세요.
• 장기 복용 후 중단 시에는 갑자기 중단하지 말고 점차 줄이세요.

 

 

CORTICOSTEROIDS (INHALATION)

 beclomethasone (be-kloe-meth-a-sone) QVAR, QVAR Redihaler 

budesonide (byoo-dess-oh-nide) Pulmicort Flexhaler, Pulmicort Nebuamp, Pulmicort Respules, Pulmicort Turbuhaler 

fluticasone (floo-ti-ka-sone) Aermony Respiclick, Armonair Digihaler, Arnuity Ellipta, Flovent Diskus, Flovent HFA 

mometasone (mo-met-a-sone) Asmanex HFA, Asmanex Twisthaler

anti-asthmatics, anti-inflammatories (steroidal) / corticosteroids (inhalation) 

● Indications: Maintenance treatment of asthma as prophylactic therapy. May decrease the need for or eliminate use of systemic corticosteroids in patients with asthma

● Therapeutic effects: Decreased frequency and severity of asthma attacks. Improves asthma symptoms

● Absorption: Beclomethasone—20%; budesonide—6– 13% (Flexhaler), 6% (Respules); fluticasone—<7% (aerosol), 8– 14% (powder); mometasone—<1%. Action is primarily local after inhala

● Distribution: 10– 25% is deposited in airways if a spacer device is not used. All cross the placenta and enter breast milk in small amounts. 

● Protein binding: 

● Metabolism&Excretion: primarily excreted in feces, metabolized by the liver / after absorption from lungs; Budesonide—60% excreted in urine, 40% in feces

● Onset/Peak/Duration: Inhalation: Onset within 24hrs, Peak 1–4 wk, Duration unknown

● ADE: EENT: dysphonia, hoarseness, cataracts, glaucoma, nasal congestion, pharyngitis, sinusitis. Endo: adrenal suppression (↓dose, long-term therapy only),↑ growth (children),↑bone mineral density. GI: diarrhea, dry mouth, dyspepsia, esophageal candidiasis, taste disturbances, nausea. MS: back pain. Neuro: headache, agitation, depression, dizziness, fatigue, insomnia, restlessness.. Resp: bronchospasm, cough, wheezing. Misc: CHURG-STRAUSS SYNDROME, HYPERSENSITIVITY REACTIONS (including anaphylaxis, laryngeal edema, urticaria, and bronchospasm)

● Dose: Budesonide (Pulmicort Flexhaler) Inhaln (Adults): 180– 360 mcg twice daily (not to exceed 720 mcg twice daily)

● contraindication: Some products contain alcohol or lactose and should be avoided in patients with known hypersensitivity or intolerance; Acute attack of asthma/status asthmaticus. 

● nursing consideration: Monitor respiratory status and lung sounds. Assess pulmonary function tests periodically during and for several mo after a transfer from systemic to inhalation corticosteroids. • Assess patients changing from systemic corticosteroids to inhalation corticosteroids for signs of adrenal insufficiency (anorexia, nausea, weakness, fatigue, hypotension, hypoglycemia) during initial therapy and periods of stress. If these signs appear, notify health care professional immediately; condition may be life-threatening