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Risk-Benefit Value of Inhaled Corticosteroids*: A Pharmacokinetic/Pharmacodynamic Perspective

Shashank Rohatagi, PhD, MBA; Hartmut Derendorf, PhD; Karl Zech, PhD
Author and Funding Information

*From Aventis Pharmaceuticals (Dr. Rohatagi), Bridgewater, NJ; Department of Pharmaceutics (Dr. Derendorf), University of Florida, Gainesville, FL; and Altana Pharmaceuticals (Dr. Zech), Konstanz, Germany.

Correspondence to: Shashank Rohatagi, PhD, MBA, Aventis Pharmaceuticals, Mail Stop: BWM-203F, Route 202–206, PO Box 6800, Bridgewater, NJ 08807-0800; e-mail: shashank.rohatagi@aventis.com



Chest. 2003;123(3_suppl):430S-431S. doi:10.1378/chest.123.3_suppl.430S-a
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Extract

Inhaled corticosteroids (ICS) induce therapeutic and adverse systemic effects mediated via the same receptor site. Analyzing pharmacokinetic/pharmacodynamic parameters of ICS helps quantify and obtain a risk-benefit value (RBV). Targeted efficacy with minimal adverse effects helps quantify an appropriate RBV. Lung deposition/targeting, receptor binding, volume of distribution, pulmonary retention, and lipid conjugation are a few of the important pharmacokinetic parameters to be considered when looking at the benefits of ICS. Oral bioavailability, particle size, and inactive drug at the oropharynx (for local side effects), plasma protein binding, rapid metabolism, high clearance, and lower systemic half-life are associated with low risks for adverse effects (Fig 1 ).

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