19.6 : 抗喘息薬：吸入コルチコステロイドおよびグルココルチコイド

Inhaled corticosteroids, or ICS, are potent anti-inflammatory drugs pivotal in asthma management. They precisely target the bronchial mucosa to control inflammation.

They effectively curb acute episodes and chronic asthma progression.

The mechanism of action of ICS is multifaceted. They restrain T_h cell clonal proliferation, reduce IL-2 gene transcription, and decrease cytokine production.

They also inhibit vasodilation and reduce mediator release from eosinophils.

Prominent ICS include beclomethasone, budesonide, fluticasone, mometasone, ciclesonide, and triamcinolone.

ICS is administered via the inhalation route. Spacers can be attached to metered-dose inhalers that can optimize drug delivery.

Potential adverse effects of ICS include oropharyngeal candidiasis, sore throat, croaky voice, and adrenal suppression at high doses. Risk mitigation involves spacer use and mouth rinsing post-inhalation.

Despite these drawbacks, consistent use of ICS can improve asthma symptoms and potentially eliminate the need for oral glucocorticoids for severe cases.