mg/day inhaled via jet nebulizer either once daily or divided into 2 doses. The maximum manufacturer recommended total dose is 1 mg/day. The National Asthma Education and Prevention Program Expert Panel defines low dose therapy for budesonide inhalation suspension as mg/day, medium dose therapy as 1 mg/day, and high dose therapy as 2 mg/day for children ages 5 to 11 years. Titrate to the lowest effective dose once asthma stability is achieved. Prolonged use of high doses, ., 2 mg/day, may be associated with additional adverse effects.
As a glucocorticoid , the lipophilic structure of prednisolone allows for easy passage through the cell membrane where it then binds to its respective glucocorticoid receptor (GCR) located in the cytoplasm. Upon binding, formation of the GC/GCR complex causes dissociation of chaperone proteins from the glucocorticoid receptor enabling the GC/GCR complex to translocate inside the nucleus. This process occurs within 20 minutes of binding. Once inside the nucleus, the homodimer GC/GCR complex binds to specific DNA binding-sites known as glucocorticoid response elements (GREs) resulting in gene expression or inhibition. Complex binding to positive GREs leads to synthesis of anti-inflammatory proteins while binding to negative GREs block the transcription of inflammatory genes.