**3.2.5 Flunisolide**

88 Otolaryngology

µg per nostril, once a day). For children between the ages of 4-11 years, half the dose is recommended. Side effects are similar to those of the other inhaled corticosteroids described

FP is eliminated from systemic circulation at a rate approximately equal to hepatic blood flow. It is metabolised through hydrolysis with the formation of 17-ß-carboxylic metabolic acid, which has insignificant anti-inflammatory and systemic activity due to incomplete absorption in the gastrointestinal tract and to extensive metabolism during the first hepatic

Comparative studies of BDP at similar doses have shown that both steroids have a similar efficacy for controlling nasal symptoms, in all cases superior to that of placebo. The speed of action is greater in fluticasone, as evidenced by the fact that significant improvement in symptoms is seen by the second day of treatment, while the delay in the onset of

Same authors found that after nasal provocation with an allergen, treatment with FP decreased obstruction in 45%, sneezing in 73%, pruritus in 78% and hydrorrhoea in 80%

Kaszuba demonstrated the efficacy of antihistamines (loratadine oral) with the use of fluticasone in nasal spray, in the treatment of seasonal AR. The conclusion was that the efficacy and decreased inflammation was greater with FP (decreased ECP, the number of eosinophils and improved scores on quality-of-life questionnaires) (Kaszuba et al, 2001).

Fluticasone furoate (FF) (Avamys; GlaxoSmithKline, London, UK) is the most recent intranasal glucocorticosteroid available for the treatment of AR (allergic rhinitis). It possesses a distinctive combination of pharmacodynamic and physico-chemical properties, which confers a high affinity for the glucocorticosteroid receptor and a potent antiinflammatory activity. This allows its effectiveness in treating both nasal and ocular symptoms to be complemented by a favorable safety and tolerance profile. In addition, the new nasal delivery device was designed according to the needs experienced and expressed by patients, which assures an optimal dispensation that promotes its extensive use. (Allen et

The compliance of the patients in treatment with intranasal corticosteroids may be influenced by both the sensorial properties of the drug and the delivery device. FF has been formulated to release a low volume (50 µl) in the form of a fine mist, with a favorable profile of sensory characteristics in terms of reduction in odor, in the posterior aftertaste, and in the

In addition to the greater affinity for the glucocorticosteroid receptor, FF shows a high selectivity for the same as compared to other intranasal glucocorticosteroids; for each FF molecule which binds to the mineralocorticoid receptor, other 800 will bind to the glucocorticosteroid receptor, which considerably limits the potential undesirable side

FF has demonstrated superior efficacy when compared to placebo in the treatment of nasal symptoms of seasonal allergic rhinitis in adults and children, and demonstrated a significant

retro-nasal dripping down the throat (Mahadevia et al, 2004; Meltzer et al, 2008).

improvement for those treated with BDP was three days (Scadding et al, 1994).

above (LaForce et al, 1994).

(Scadding et al, 1994).

**3.2.4 Fluticasone furoate** 

effects.

al, 2007; Rosenblut et al, 2007; Baumann et al, 2009).

step.

Introduced in 1978, flunisolide is a poorly water-soluble drug, which is therefore dissolved in propylene glycol and water (Horan & Johnson, 1978; Schulz et al, 1978). Rhinoscopy is recommended once a year for prolonged treatment.
