Salmeterol ticarcoson is known by the trade name sulpiride, and budesonide formoterol, known by the trade name Cinpecol DuPont. They are the two most commonly used inhaled medications for symptom control in patients with asthma and COPD.

Both drugs are compounded and consist of an inhaled glucocorticoid + a long-acting beta2 agonist.

1. Composition of Cymbicort Dupo: Budesonide + Formoterol (two sizes: 80ug/4.5ug, 160ug/4.5ug)

2. Composition of sulpiride: fluticasone + salmeterol (three sizes: 100ug/50ug, 250ug/50ug, 500ug/50ug)

Why are they compounded?

Inhaled glucocorticoids in combination with beta agonists in a compounded formulation can act synergistically with each other at the molecular level to enhance the effect.

Glucocorticoids are able to increase the number of receptors in smooth muscle cells, and beta2 agonists are able to activate the receptors, thus making them more sensitive to hormonal molecules. In turn hormones are able to ameliorate the phenomenon of hypersensitivity and tolerance that occurs in the body because of prolonged use of beta receptors.

The difference between the two drugs:

1. Fluticasone and budesonide are both inhaled glucocorticosteroids, but fluticasone has the strongest effect among the inhaled hormones, so the anti-inflammatory effect of fluticasone is much stronger than that of budesonide, and therefore the anti-inflammatory effect of sulpiride is stronger than that of xinpecia.

In addition, because fluticasone has a high lipid solubility, its local selectivity is high, and its oral bioavailability is lower than that of budesonide, so the amount that passes through the oropharynx into the systemic circulation during inhalation is less, and the systemic adverse effects are relatively small.

2. Formoterol and Salmeterol are both long-acting selective β2 agonists, and they work by relaxing bronchial smooth muscle and relieving airway spasm. Only formoterol is a fast-acting bronchodilator, which can take effect 1-3 minutes after inhalation, while salmeterol takes 10-20 minutes to take effect.

Therefore, Sulodexide can only be used for long-term symptom control and cannot be used as a first aid during an acute attack of asthma or COPD. In contrast, Symbicort DuPont can not only be used for long-term symptom control, but can also be used as a first aid during an acute attack of asthma or COPD (which requires a higher dosage).

3. Efficacy: Guidelines for both COPD and asthma state that there is no significant difference between the two drugs in terms of improvement in lung function in patients. However, some studies have shown that Cymbicort may be superior to Solitia in the long-term control of asthma. However, sulpiride has a high hormone content and provides better control in severe patients.

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Salmeterol ticarcoson inhaler (sulpiride) and budesonide formoterol inhaler (Cymbalta) are the same in terms of the principle of the drug's formulation, which is made up ofInhaled glucocorticoids and long-acting β2 agonistscompounded; the combination of these two types of drugs can beActs synergistically (1+1>2) to reduce glucocorticoid dosage.The drug ingredients of salmeterol ticarcoson inhaler are fluticasone propionate and salmeterol, and the ingredients of budesonide formoterol inhaler are budesonide and formoterol. The two have some differences in action due to the different drug ingredients.

By way of comparison.Fluticasone propionate has a higher lipid solubility and higher affinity for the receptor, as well as a low bioavailability after absorption through the gastrointestinal tract(With inhalation medications, there is also a portion of the medication deposited in the oropharynx that enters the gastrointestinal tract via swallowing, and of course this portion of the medication that enters the gastrointestinal tract is the portion that we don't want to have.); but on the other hand, there is a portion of the medication in theUse of budesonide and fluticasone propionate with equivalent clinical efficacywhenThere is no detailed evidence-based proof of which drug has a better safety profile。

Formoterol, compared with salmeterol, has both long-acting and fast-acting featuresThis is the biggest difference between Sulodexide and Symbicort. This is the biggest difference between Salmeterol and Symbicort. Significant bronchodilatory effects are observed 10-20 minutes after inhalation for salmeterol, and 2-5 minutes after inhalation for formoterol, with similar maintenance times of about 12 hours for both.

In addition to the differences in drug action properties, there is one other small difference between the two:The remaining doses of sulpiride are marked one by one in the counting window, whereas the remaining doses of Symbicort are counted every 20 marks., thus making it easier for patients to check the remaining dosage of Sulodexide.

The two dry powder inhalers budesonide formoterol and salmeterol fluticasone are the most commonly used clinically for the control of bronchial asthma and chronic obstructive pulmonary disease in the stable phase, both drugs are composed of an inhaled glucocorticoid and a bronchodilator, which can fight airway inflammation and calm the wheezing, and regular long-term use can reduce the acute exacerbation of bronchial asthma and chronic obstructive pulmonary disease and protect the lung function, and the difference between them is also It's a bit of a learning curve.

First of all, these two medications are both inhalers, and they have different inhalation devices. The inhalation device for budesonide formoterol is called a "dubo", and the inhalation device for salmeterol fluticasone is called a "quasi-nasalizer", which is long, and the quasi-nasalizer is round. The "Dupo" is long and the "Para-Nar" is round. The "Para-Nar" has a counting window so that you can see the number of inhalations and the amount of medication remaining, while the "Dupo" does not have a counting window. Dupont has a counting window so that you can know the number of inhalations and the amount of medicine left, while Dupont does not have a counting window. Dupont has a high resistance to inhalation, which makes inhalation difficult, while Quasi Nano has a low resistance to inhalation, which makes inhalation easier, and Quasi Nano has a higher lactose content, which makes inhalation sweet. The content of lactose in "Quasi Nano" is higher, which makes inhalation feel sweet and increases your self-confidence and adherence to medication, while the content of lactose in "DuPao" is lower, which makes inhalation feel senseless, and you don't know whether it has been inhaled or not.

There are also differences in efficacy between the two medications, starting with the two inhaled glucocorticosteroids budesonide and fluticasone, fluticasone has a stronger anti-inflammatory effect and a longer duration of action, while budesonide has a faster onset of action, and is the only FDA-approved inhaled glucocorticosteroid that can be used during pregnancy. The two bronchodilators, formoterol and salmeterol, formoterol has a faster onset of action, with an onset of action in 3 minutes, similar to that of albuterol, and therefore can be used in acute exacerbations of bronchial asthma and chronic obstructive pulmonary disease (COPD) and can be carried on the person, whereas salmeterol takes 30 minutes to have an onset of action and is not suitable for use in acute exacerbations of bronchial asthma and COPD, and should also be carried on the person with albuterol.

To summarize, fluticasone has a stronger anti-inflammatory effect than budesonide, and formoterol has a faster onset of action than salmeterol. Budesonide formoterol has a fast onset of action and can be used in emergency situations for rapid relief of breath-holding symptoms and can be carried around, while salmeterol fluticasone has a good anti-inflammatory efficacy and is suitable for controlled maintenance therapy in the stabilized phase of bronchial asthma and chronic obstructive pulmonary disease.

References:

Chinese Expert Consensus on Diagnosis and Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease (2017 Update)

Guidelines for the Management of Bronchial Asthma (2016 Edition)

More people suffer from respiratory diseases such as asthma and COPD due to external factors such as air pollution, smog, dust and their own factors. However, in order not to affect work and life, we need to use long-term standardized medication to control symptoms and reduce the recurrence of their diseases.

Budesonide formoterol powder inhaler (CyberKnife DuPont) and salmeterol ticarcoson powder inhaler (Sulodexide) are both dry powder inhalation preparations consisting of inhaled glucocorticoid + long-acting β2 agonist, which combine to have synergistic anti-inflammatory and asthma-relieving effects, and are two of the most commonly used symptom-controlling inhalation medications for asthma and chronic obstructive pulmonary disease (COPD) patients. So what is the difference between these two inhalers?

1. Budesonide and formoterol for budesonide powder inhaler (CyberKnife), and salmeterol ticarcoson for salmeterol powder inhaler (Solidex): fluticasone propionate and salmeterol.

2. Budesonide and fluticasone propionate are both inhaled glucocorticoids. Budesonide is moderately fat-soluble and water-soluble, and can more easily pass through the mucus layer and cell membrane of the airway epithelial surface to exert anti-inflammatory effects rapidly; fluticasone propionate has lower water-solubility, which leads to its slow dissolution in the mucus layer of the bronchial mucosa, and thus the onset of action is slower than that of budesonide. However, fluticasone propionate is stronger than budesonide in antagonizing and eliminating respiratory allergic inflammation.

3. Formoterol and salmeterol are both long-acting β2-agonists. Formoterol has a faster onset of action than salmeterol, with formoterol having an onset of action 1-3 minutes after inhalation, whereas salmeterol takes 10-20 minutes to have an onset of action, but both have a maintenance time of approximately 12 hours. Thus budesonide formoterol powder inhaler is more rapid than salmeterol ticarcoson powder inhaler in controlling acute asthma attacks.

4. While salmeterol ticarcoson powder inhaler is a fixed, non-incremental dose to be used throughout the day, budesonide formoterol powder inhaler can be increased, and can be used by the patient on an as-needed basis for palliative control of the condition during exacerbations of the symptoms, in addition to the daily maintenance dose. However, the total daily dose of budesonide formoterol powder inhaler should not normally exceed 8 puffs, but may be temporarily used up to 12 puffs.

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As a clinician, you should be able to talk to your patients in the simplest terms, without going too far and too complicated.

Salmeterol ticarcoson powder inhaler, trade name "Sulodexide".

Budesonide formoterol inhaler, trade name "Cymbicort".

For the sake of typing, let's just say the trade name.

First of all, Sulodexide and Symbicort are two very good medications used to treat asthma.

Both of these medications are compounded, as you can see from the names, with sulpiride consisting of salmeterol + fluticasone, and xinpirox consisting of formoterol + budesonide. Both salmeterol and formoterol are long-acting bronchodilators, while fluticasone and budesonide are inhaled glucocorticoids.

In other words, sulforaphane and xinpecia are both composed of an inhaled hormone and a long-acting bronchodilator.

In terms of the current research evidence, there is more evidence for Cymbicort, for example, for bronchial asthma, Cymbicort seems to be more advantageous because it works very quickly and can be used not only for usual asthma control, but also as an emergency remedy (formoterol calms asthma very quickly and works in a few minutes), whereas salmeterol is slow to work and is not suited for use as an emergency remedy. However, an asthmatic who is having a really acute attack is sometimes not able to use Cymbalta very well, because Cymbalta requires you to inhale hard. It's hard to breathe when you're out of breath, let alone inhale a medicine hard. So, Symbicort can't always be used in an emergency.

If you really want to give first aid, it is still more advantageous to use aerosols such as salbutamol aerosol and terbutaline aerosol. The patient only needs to open his mouth, and then inhale while the spray is being given, which is simpler and less laborious than using Cymbalta.

What about sulpiride? There is relatively less evidence compared to Symbicort, but the evidence is also strong. A big reason why there is less evidence now is because of a bribery scandal at the company a few years ago, and these are political battles now, so it's hard to say whether they have much to do with drugs. There's no question that Soledad is a good drug, too. And sulpiride has a bit of a flavor, you can tell when you inhale it if you do inhale it. And Cymbalta doesn't have a flavor, and sometimes you don't even know if you've inhaled the drug or not.

Also, the device, sulpiride, has a total of 60 inhalations, and with one inhalation, the number goes down by one to 59, which Shinobi is not.

Overall, both are good medicines. There is no essential difference between the Sword of Heaven and the Dragon Slayer.

These two medications are very commonly used in respiratory medicine; salmeterol ticametasone inhaler is known by the trade name of sulpiride and budesonide formoterol inhaler is known by the trade name of cinpecidumab. They are both inhaled combinations of a glucocorticoid combined with a long-acting beta-blocker. The two components of the combination therapy have a synergistic effect, both anti-inflammatory and asthma calming effect, so it has the advantages of fast onset, good efficacy and long duration of action. It is recommended by major asthma guidelines and requires long-term use.

How should I choose between these two medications when using them for patients with chronic obstructive pulmonary disease and bronchial asthma, and what exactly is the difference between these two medications?

1. Different drug composition Salmeterol + fluticasone propionate is used in Sulodexide, and Formoterol + Budesonide is used in CyberKnife. Salmeterol and formoterol are both long-acting beta agonists, and fluticasone propionate and budesonide are both glucocorticoids.

2. Different onset of action time Formoterol works faster than salmeterol, so Cyprodinil works faster, taking three minutes to take effect. The onset of action of sulpiride is relatively slow, it takes 15 minutes to take effect, so when you inhale sulpiride, you usually need to add a fast-acting drug such as salbutamol.

3. Safety aspect The hormone content of Sulidian is 4 times more than that of CyberKnife Dupont, and there are many side effects of hormones on the body, so Sulidian can only be taken twice in a day, and cannot be added more. The hormone ingredient of CyberKnife is Budesonide, which is a class B hormone recognized by FDA and can be used on pregnant patients, so the safety is unquestionable. Therefore, Symbicort can be added anytime when the symptoms are severe, up to 6 puffs at a time, twice a day. However, because both are topical medications, overall side effects are minor.

4. The efficacy of the drug Fluticasone propionate is the strongest inhaled hormone with anti-inflammatory activity in the country, stronger than budesonide. Therefore, the anti-inflammatory effect of sulpiride is slightly stronger. From the research data, the proportion of Sulidian to achieve the asthma control treatment goal is higher, but if we talk about symptomatic relief, Xinbike is faster.

For patients with bronchial asthma and COPD, both medications are available, and there is no significant difference in their effects in terms of long-term results in controlling symptoms. The choice of which one to take lies in the patient's tolerance of the different medications and the effects produced by their use.

Salmeterol ticarcoson inhaler and budesonide formoterol inhaler are the two kingpin drugs in respiratory medicine and the first-line drugs recommended by major asthma guidelines. Currently, the main clinical applications are sulpiride (salmeterol ticarcoson powder inhaler) and cinpecidumab (budesonide formoterol powder inhaler), both of which are long-term treatments for patients with bronchial asthma and chronic obstructive pulmonary disease (chronic obstructive pulmonary disease, or COPD for short). What is the difference between the two?

I. Differences in composition

Both are compounded and share the common characteristic of being composed of a combination of beta agonists and glucocorticoids, which are effective in the treatment of bronchial asthma and chronic obstructive pulmonary disease, and are also the guideline-recommended dosing regimen.

Sulidian (salmeterol ticarcoson powder inhaler) is composed of salmeterol and fluticasone propionate. It is available in two different sizes: 1) Salmeterol (50 mcg/inhaled) and fluticasone propionate (100 mcg/inhaled); 2) Salmeterol (50 mcg/inhaled) and fluticasone propionate (250 mcg/inhaled).

Symbicort Dupo (budesonide formoterol powder inhaler) is composed of budesonide and formoterol fumarate. It is also available in two different sizes respectively 1. budesonide (80 μg/inhaled) and formoterol fumarate (4.5 μg/inhaled); and 2. budesonide (160 μg/inhaled) and formoterol fumarate (4 μg μg/inhaled).

Among them, salmeterol and formoterol are both long-acting β2 agonists, whose main effect is to dilate the bronchial tubes and relieve airway spasm. And fluticasone and budesonide both are glucocorticoids with powerful anti-inflammatory effects.

II. Differences in time of entry into force

The onset of action of Sulodexide is about 15-20 minutes, while the onset of action of Symbicort is about 3 minutes, and the patient's feeling is already more obvious after 5 minutes of use. Therefore, for patients with bronchial asthma and COPD who are experiencing exacerbations, the use of CyberKnife is more effective and symptomatic.

III. Differences in role characteristics

1, fluticasone and budesonide comparison, inhaled glucocorticoid fluticasone propionate is currently known as the airway anti-inflammatory strength of the largest inhaled glucocorticoid, has a high fat solubility, its fat solubility is 300 times that of budesonide, and the water solubility is also 1,350 times that of budesonide, these characteristics determine fluticasone propionate local anti-inflammatory activity is significantly stronger than that of budesonide, which is to say, sulpiride's therapeutic The upper therapeutic limit of sulpiride is higher than that of Cymbicort.

2, salmeterol and formoterol comparison, formoterol is a β2 receptor full agonist, with high performance, high intensity, and the effect of the dose-dependent relationship, the onset of action time is only 3 minutes, the effect of a long duration. Salmeterol has a slower onset of action, taking 15-20 minutes to take effect. In addition, formoterol is mainly metabolized by the liver, while salmeterol is excreted in urine and feces, so there is a difference in the way of elimination between the two.

To summarize: the pharmacological effects of sulpiride (salmeterol ticarcoson powder inhaler) and xinpidine (budesonide formoterol powder inhaler) are generally the same, and the difference is relatively small. If bronchial asthma or chronic obstructive pulmonary disease (COPD) is in acute attack, it is recommended to choose xinpidine for faster onset of action, and if sulpiride is chosen, it is necessary to add a fast-acting β2 agonist, such as salbutamol. If the inflammation is severe, it is recommended to choose sulpiride for its more potent anti-inflammatory effect. If liver insufficiency is present, it is recommended to choose sulpiride for its relatively low impact on the liver.

References:

Pharmacology - People's Health Publishing House. 8th ed.

I've used it and it basically doesn't work very well, so I guess it varies from person to person!

The effect of these two inhalers is not obvious, and salbutamol can be used in the case of seizures.

I use salmeterol ticarcoson inhaler and have never used budesonide formoterol inhaler, can I alternate between the two?