What is low dose inhaled corticosteroids

The presence of the isotope plutonium-240 in a sample limits its nuclear bomb potential, as plutonium-240 has a relatively high spontaneous fission rate (~440 fissions per second per gram—over 1,000 neutrons per second per gram), [15] raising the background neutron levels and thus increasing the risk of predetonation . [16] Plutonium is identified as either weapons-grade , fuel-grade, or reactor-grade based on the percentage of plutonium-240 that it contains. Weapons-grade plutonium contains less than 7% plutonium-240. Fuel-grade plutonium contains from 7% to less than 19%, and power reactor-grade contains 19% or more plutonium-240. Supergrade plutonium , with less than 4% of plutonium-240, is used in . Navy weapons stored in proximity to ship and submarine crews, due to its lower radioactivity. [17] The isotope plutonium-238 is not fissile but can undergo nuclear fission easily with fast neutrons as well as alpha decay. [4]

Linagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor, which exerts its actions in patients with type 2 diabetes by slowing the inactivation of incretin hormones. Concentrations of the active, intact hormones are increased by linagliptin, thereby increasing and prolonging the action of these hormones. Incretin hormones, including glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are released by the intestine throughout the day, and levels are increased in response to a meal. These hormones are rapidly inactivated by the enzyme, DPP-4. The incretins are part of an endogenous system involved in the physiologic regulation of glucose homeostasis. When blood glucose concentrations are normal or elevated, GLP-1 and GIP increase insulin synthesis and release from pancreatic beta cells via intracellular signaling pathways involving cyclic AMP. GLP-1 also lowers glucagon secretion from pancreatic alpha cells leading to reduced hepatic glucose production, and GLP-1 slows gastric emptying time. Linagliptin increases insulin release and decreases glucagon levels in the circulation in a glucose-dependent manner; GLP-1 does not increase insulin secretion when the glucose concentration is less than 90 mg/dL. Linagliptin is of benefit in patients with type 2 diabetes mellitus as their GLP-1 concentrations are decreased in response to a meal. Linagliptin selectively and reversibly inhibits DPP-4. In vitro studies have shown that at 1 nmol/L, linagliptin inhibits DPP-4 by 50% making it the most potent of the DPP-4 inhibitors. These in vitro results appear to be relevant to in vivo results. The long-term safety of DPP-4 inhibitors are currently under investigation as DPP-4 is not an enzyme specific for the breakdown of incretin hormones. In fact, DPP-4 is responsible for the metabolism of many peptides including peptide YY, neuropeptide Y, and growth hormone-releasing hormone. DPP-4 is involved with T-cell activation and is expressed on lymphocytes as CD26. It is not clear whether there are long-term neurological or immunological consequences of inhibiting DPP-4.

In an embryofetal development study in pregnant rabbits, beclomethasone dipropionate administration during organogenesis from gestation days 7 to 16 at subcutaneous doses equal to and greater than  times the MRHDID in adults (on a mg/m 2 basis at maternal doses of  mg/kg/day and higher) produced external and skeletal malformations and embryolethal effects (increased fetal resorptions). There were no effects in fetuses of pregnant rabbits administered a subcutaneous dose  times the MRHDID in adults (on a mg/m 2 basis at a maternal dose of  mg/kg/day).

There are no available data on the presence of fluticasone propionate in human milk, the effects on the breastfed child, or the effects on milk production. Other corticosteroids have been detected in human milk. However, fluticasone propionate concentrations in plasma after inhaled therapeutic doses are low and therefore concentrations in human breast milk are likely to be correspondingly low [see Clinical Pharmacology ()] . The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Flovent HFA and any potential adverse effects on the breastfed child from Flovent HFA or from the underlying maternal condition.

What is low dose inhaled corticosteroids

what is low dose inhaled corticosteroids

There are no available data on the presence of fluticasone propionate in human milk, the effects on the breastfed child, or the effects on milk production. Other corticosteroids have been detected in human milk. However, fluticasone propionate concentrations in plasma after inhaled therapeutic doses are low and therefore concentrations in human breast milk are likely to be correspondingly low [see Clinical Pharmacology ()] . The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Flovent HFA and any potential adverse effects on the breastfed child from Flovent HFA or from the underlying maternal condition.

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