Fluticasone

Question 1

What are some other drugs in the same class as fluticasone?

Answer 1

Beclomethasone, Budesonide, Ciclesonide, Flunisolide, Mometasone

Question 2

What is fluticasone used for?

Answer 2

the prophylaxis of asthma.

Also used as nasal spray for treatment+prevention of allergic rhinitis

Question 3

What is the mechanism of action of fluticasone?

Answer 3

It is a human glucocorticoid receptor agonist. Glucocorticoids inhibit many immune markers including mast cells, eosinophils, basophils, lymphocytes, macrophages and neutrophils, leukotrienes, cytokines and eicosanoids

Question 4

What are important pharmacokinetic/pharmacodynamic properties of fluticasone?

Answer 4

Extensively metabolised in the liver
A huge proportion undergoes FPM
Metabolite is inactive
Majority of excretion is the faeces
Elimination half life of 6.1hours

Question 5

What are the precautions associated with fluticasone?

Answer 5

risk of glaucoma, cataracts, increased ocular pressure
history of diabetes
hepatic impairment
Immunosuppression

Question 6

What are some contraindications associated with fluticasone?

Answer 6

Patient hypersensitivity to any component of product or to milk proteins

Primary treatment of status asthmaticus requiring intensive intervention

Systemic infection

Question 7

What are the adverse effects associated with fluticasone?

Answer 7

Common: epistaxis, Nose & throat dryness, unpleasant taste and smell

Question 8

What are some interactions with fluticasone?

Answer 8

Potent CYP3A4 inhibitors like ketoconazole and ritonavir may increase toxicity from fluticasone via inhibition of metabolism.

May interact with salmeterol to cause hypokalaemia and paradoxical bronchospasm

Question 9

What are the alarm bells regarding fluticasone?

Answer 9

Watch ocular pressure and for any signs of infection as well as potassium levels if taken with salmeterol