Fluticasone propionate (Flovent)
Fluticasone Furoate (Arnuity Ellipta)
Fluticasone proprionate and salmeterol (Advair Discus)
efficiently inactivates CYP 450 3A5, a predominant lung P450 lung enzyme
Indications: treatment including maintenance and prophylaxis of chronic asthma patients including those that require systemic dose reduction/elimination
MOA: Adrenal corticosteroids with basic glucocorticoid activity and actions--exact mechanism in the lung tissue is unknown--local lung delivery can reduced the systemic glucocorticoid activity
Warnings: deaths have occurred due to adrenal insufficiency in asthmatic patients both during and after transder from systemic corticosteroids to inhaled corticosteroids, after withdrawl of systemic agents it takes several months for hypothalamic pituitary adrenal function to return to nromal adrenal insufficiency will manifest itseld during trauma, surgery or infection---use extreme caution---be on lookout of severe asthmatic attack
Halogen incorporation increases lipid solubility
Patient info: rinse mouth out without following to avoid oral candidiasis
Do not abruptly stop use or use to treat an acute attack