Effects of Low and High Doses of Inhaled Flunisolide and Triamcinolone Acetonide on Basal and Dynamic Measures of Adrenocortical Activity in Healthy Volunteers
The objective of this study was to evaluate the effects of inhaled flunisolide (FN) and triamcinolone acetonide (TAA) on basal and dynamic adrenocortical activity. A randomized cross-over design was used, comparing placebo (PL), low (L) and high (H) doses of FN (Aerobid; 250 mg/actuation; without spacer; L, 1000 mg; H, 2000 mg/ day), and TAA (Azmacort; 100 mg/actuation; with integrated actuator/ spacer; L, 800 mg; H, 1600 mg/day). Each dose was given at 0800 and 2200 h for 3 days, and treatments were separated by a 10-day wash- out. Twelve normal volunteers (mean 6 SE age, 24.2 6 2.4 yr) were studied. After 3 days of treatment, blood samples were taken before ACTH stimulation at 0800 h (10 h after the sixth dose) and after ACTH (0.5 mg) stimulation for determination of serum cortisol. Over- night (starting at 2200 h on the third day of treatment) and early morning urine collections were taken for measurements of urinary cortisol corrected for creatinine excretion. For serum cortisol (pre- and post-ACTH stimulation), there was no significant difference compared with placebo for either drug. Post- ACTH cortisol (nanomoles per L) values were: PL, 666.3; H FN, 617.0;