Inhaled Corticosteroids (Budesonide): the Cornerstone of Asthma Therapy – What are the Options?

2002 ◽  
Vol 15 (6) ◽  
pp. 479-484 ◽  
Author(s):  
R.M. Angus
Keyword(s):  
Inhaled Corticosteroids ◽  
Asthma Therapy

Hypoglycemia and Cortisol Deficiency Associated With Low-dose Corticosteroid Therapy for Asthma

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 921-924
Author(s):  
Aaron L. Carrel ◽  
Stephanie Somers ◽  
Robert F. Lemanske ◽  
David B. Allen
Keyword(s):  
Adverse Effects ◽  
Low Dose ◽  
Inhaled Corticosteroids ◽  
Chronic Asthma ◽  
Asthma Therapy ◽  
Biochemical Alterations ◽  
Clinically Significant ◽  
Dose Corticosteroid ◽  
Oral Glucocorticoids ◽  
Cortisol Deficiency

Glucocorticoids are a cornerstone of the anti-inflammatory treatment of asthma. To minimize adverse effects of oral glucocorticoids (OGC), clinicians have used alternate-day oral or inhaled corticosteroids (IC), both generally considered safe for chronic asthma therapy in children. Although reversible growth suppression occasionally occurs, the general consensus is that, despite detectable biochemical alterations, these modes of therapy are not associated with clinically significant adrenal insufficiency.1 We report the occurrence of hypoglycemia due to cortisol deficiency during combination alternate-day oral and inhaled corticosteroids. CASE HISTORY A 3½-year-old boy with asthma was found one morning to be unarousable, limp, and blue around the lips.

Inhaled Corticosteroids for Asthma Therapy

CHEST Journal ◽  
2000 ◽  
Vol 117 (2) ◽  
pp. 542-550 ◽  
Author(s):  
Mac G. Cochrane ◽  
Mohan V. Bala ◽  
Kristen E. Downs ◽  
Josephine Mauskopf ◽  
Rami H. Ben-Joseph
Keyword(s):  
Inhaled Corticosteroids ◽  
Asthma Therapy

scholarly journals Moderate Dose Inhaled Budesonide Disguising Symptoms of Addison's Disease in An Asthmatic Boy with Silent Celiac Disease

2005 ◽  
Vol 10 (2) ◽  
pp. 100-103
Author(s):  
Lars C. Stenhammar ◽  
Lotta M. Högberg ◽  
Maria Nordwall ◽  
Leif G. E. Strömberg
Keyword(s):  
Celiac Disease ◽  
Inhaled Corticosteroids ◽  
Addison’S Disease ◽  
Late Childhood ◽  
Addison's Disease ◽  
Asthma Therapy ◽  
First Line ◽  
Symptom Pattern ◽  
Inhaled Budesonide ◽  
Pituitary Adrenal Axis

Inhaled corticosteroids are first-line treatment for asthma. Moderate doses of budesonide have been supposed not to affect hypothalamic-pituitary-adrenal axis function. We report the case of a boy with asthmatic symptoms and a late diagnosis of celiac disease, in whom inhaled budesonide in a dose used in conventional asthma therapy seems to have been systemically absorbed in amounts large enough to temporarily disguise the symptoms of a developing adrenal insufficiency. Inhaled corticosteroids in a dose used in standard asthma therapy seem to have the potential of disguising a developing Addison's disease. Furthermore, celiac disease, especially if diagnosed in late childhood, may be associated with Addison's disease causing a complex symptom pattern.

ОСОБЕННОСТИ ЛЕЧЕНИЯ БРОНХИАЛЬНОЙ АСТМЫ В ПЕРИОД БЕРЕМЕННОСТИ

2019 ◽  
Author(s):  
O.V. Lavrova ◽  
M.A. Petrova ◽  
G.B. Fedoseev
Keyword(s):  
Pregnant Women ◽  
Bronchial Asthma ◽  
Pregnancy Complications ◽  
Inhaled Corticosteroids ◽  
Combined Therapy ◽  
Persistent Asthma ◽  
Asthma Therapy ◽  
Complete Control ◽  
Basic Therapy ◽  
Standard Procedures

Цель. Анализ характера терапии бронхиальной астмы, а также течения беременности у пациенток с бронхиальной астмой в период с 2002 по 2017 г. Материалы и методы. С 2002 по 2017 г. обследованы и проходили наблюдение в период беременности 3890 пациенток, страдающих бронхиальной астмой. Проводилось комплексное клинико-функциональное обследование. Пациентки находились под наблюдением акушера-гинеколога весь срок беременности, проходили стандартное обследование, оценивалась частота осложнений беременности. Было проведено сравнение характера базисной терапии бронхиальной астмы в группах пациенток с персистирующим течением заболевания, наблюдавшихся с 2002 по 2009 г. (1-я группа) и с 2010 по 2017 г. (2-я группа) в сопоставлении с частотой встречаемости осложнений беременности в данных группах. Результаты. При сравнении частоты встречаемости угрозы прерывания беременности, гипертензивных расстройств, преэклампсии выявлена достоверно более низкая частота встречаемости этих осложнений беременности во 2-й группе (2010-2017 гг.). При этом частота назначения ингаляционных глюкокортикостероидов (ИГКС) в составе комбинированных препаратов возросла с 21,79 до 63,87, что практически в три раза превышает данный показатель в 1-й группе (2002-2009 гг.). Заключение. При сопоставлении изменений в характере базисной терапии, произошедших с 2002 по 2017 г., с достоверным снижением частоты встречаемости осложнений беременности в группе, наблюдавшейся с 2010 по 2017 г., можно предположить, что именно терапия комбинированными препаратами ИГКС/ агонистов Р2-адренорецпторов длительного действия позволяет наиболее полноценно обеспечивать контроль бронхиальной астмы, приводя к снижению частоты осложнений беременностиStudy goal. To analyse asthma therapy in pregnant women with bronchial asthma at a period since 2002 to 2017. Materials and methods. 3890 pregnant women with asthma were examined and followed up during pregnancy at a period since 2002 to 2017. Comprehensive clinicalfunctional examination was conducted. Patients were under surveillance of the obstetriciangynecologist during the whole pregnancy, standard procedures were carried out, and the frequency of complications of pregnancy was estimated. Basic therapy of asthma was compared in groups with the persistent asthma duration, followed up since 2002 to 2009 (1 group) and since 2010 to 2017 (2 group). Also, frequency of pregnancy complications was estimated in these groups. Results. The second group (2010-2017) demonstrated reliably lower frequency of threatening abortion, hypertension and preeclampsia. At the same time the frequency of inhaled corticosteroids (ICS) administration as a part of the combined therapy increased from 21.79 to 63.87 (almost to three times) in comparison with the first group (2002-2009). Conclusions. Combined therapy with ICS/LABA provides most complete control of bronchial asthma, and decreases frequency of pregnancy complications in pregnant women with BA.

Acute Asthma Therapy

1996 ◽  
Vol 17 (11) ◽  
pp. 404-404
Keyword(s):  
Inhaled Corticosteroids ◽  
Acute Asthma ◽  
Current Treatment ◽  
Asthma Therapy ◽  
Concerted Effort ◽  
Inhaled Steroids ◽  
Acute Exacerbations ◽  
Asthma In Children ◽  
Exercise Induced

A reader noted: "I am surprised to find no mention of inhaled steroids in the article by Drs. Murphy and Kelly `Advances in Management of Acute Asthma in Children' (July 1996). Their article is the only one I have come across that avoids mentioning the use of inhaled corticosteroids in children during the last 4 to 5 years when there seems to be a concerted effort to get pediatricians to use them." Drs. Kelly and Murphy respond: "We appreciate your concerns about our lack of discussion of inhaled corticosteroids. However, our charge for the article was to review the current treatment of acute exacerbations of asthma, including exercise-induced bronchospasm.

scholarly journals The impact of inhaled corticosteroids on cough and bronchial hyperreactivity in cough variant asthma

2010 ◽  
Vol 63 (3-4) ◽  
pp. 170-174 ◽  
Author(s):  
Ivana Stankovic ◽  
Tatjana Pejcic ◽  
Milan Rancic ◽  
Branislava Milenkovic
Keyword(s):  
Chronic Cough ◽  
Airway Hyperresponsiveness ◽  
Therapeutic Approach ◽  
Inhaled Corticosteroids ◽  
Bronchial Hyperresponsiveness ◽  
Asthma Therapy ◽  
Cough Variant Asthma ◽  
Group A ◽  
Group B ◽  
The Impact

Introduction Classic asthma is characterized by cough, wheezing and dyspnea. Cough, however, may be the sole presenting symptom of asthma and this type of asthma is known as cough-variant asthma. The therapeutic approach to cough variant asthma is similar to that of the typical form of asthma. A diagnosis of cough-variant asthma is made when a chronic cough is associated with airway hyperresponsiveness and a favorable response to asthma therapy in the absence of other discernible cause. The aims of this study were to analyze the influence of inhaled corticosteroids on cough and bronchial hyperresponsiveness. Material and methods The study included 55 patients with cough as the sole presenting symptom. 40 patients (Group A) were treated with inhaled corticosteroids and beta2 agonists for eight weeks while 15 patients (Group B) were treated only with oral beta2 agonists. The non-specific bronchoprovocative test with histamine was performed on all the patients before the treatment and after the examination and there was established the provocative dose of histamine causing the 20% fall in FEV1 (PD20). Results At the end of the study in Group A we found a statistically significant decrease of PD20 0.98?0.86 vs 1.58?1.06 (p<0.005), while in Group B there were no significant changes. In 90% of the patients treated with inhaled corticosteroids the cough was completely relieved while in 80% of the patients treated with only beta2 agonists the cough has remained unchanged. Conclusion Inhaled corticosteroids are choice drugs for the treatment of cough-variant asthma because they relieve cough and decrease bronchial hyperresponsiveness, thus ultimately reducing the risk of classic asthma.

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