Local side-effects during 4-year treatment with inhaled corticosteroids - a com between pressurized metered-dose in and Turbuhaler®

Allergy ◽  
1994 ◽  
Vol 49 (10) ◽  
pp. 888-890 ◽  
Author(s):  
O. Selroos ◽  
R. Backman ◽  
K.-O. Forsén ◽  
A.-B. Löfroos ◽  
M. Niemistö ◽  
...  
Keyword(s):  
Side Effects ◽  
Inhaled Corticosteroids ◽  
Metered Dose ◽  
Local Side

scholarly journals Severe Oro-laryngeal Thrush Following Excessive Use of Steroid Inhaler

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Marina MB ◽  
Ramli R ◽  
Primuharsa Putra SHA
Keyword(s):  
Side Effects ◽  
Muscle Power ◽  
Inhaled Corticosteroids ◽  
Fungal Infections ◽  
Complete Recovery ◽  
Asthmatic Patients ◽  
Inhaled Steroids ◽  
Laryngeal Mucosa ◽  
Loss Of Appetite ◽  
Local Side

Introduction: Inhaled steroids such as fluticasone propionate and beclomethasone dipropionate play an important role in the treatment of bronchial asthma. Its usage facilitates disease control in asthmatic patients, resulting in improved quality of life. Because of its benefit, the inhaled steroid is used extensively, at higher doses and for longer duration. However, the localized effects of inhaled corticosteroids on oral/laryngeal mucosa, such as fungal infections can be problematic. Case Report: We report a case of oropharyngeal and laryngeal candidiasis following a long period and high doses of inhaled steroid in a 42-year-old male. He presented with a complaint of increasing tiredness, phlegm, intermittent wheezing and hoarseness for 2-3 months. There was no weight loss or loss of appetite. He has been using inhaled steroids and long acting bronchodilators in increasing doses for his claimed ‘wheezing’ despite the negative history of asthma. The inhaled steroids were fluticasone dipropionate at doses of 500-100 mcg daily for 2-3 months. Results: Examination revealed widespread oral thrush involving the oral cavity, oropharynx and larynx. There was no cushingoid habitus. His muscle power was of 5/5 bilaterally and his lungs were clear. Lung function and chest film were also normal. The steroid was stopped immediately and flucanozole and nystatin syrup were prescribed. The patient made an uneventful and complete recovery. Conclusion: We conclude that patients on inhaled corticosteroids should be monitored for local side effects. Physicians should be aware not only of the systemic but also of the local side effects of inhaled corticosteroids. Patients may increase doses without the knowledge of their physicians and subsequently suffer the adverse effects either local or systemic.

The Local Side Effects of Inhaled Corticosteroids

CHEST Journal ◽  
2004 ◽  
Vol 126 (1) ◽  
pp. 213-219 ◽  
Author(s):  
Nicholas J. Roland ◽  
Rajiv K. Bhalla ◽  
John Earis
Keyword(s):  
Side Effects ◽  
Inhaled Corticosteroids ◽  
Local Side

scholarly journals Voice changes associated with inhaled steroids 1n obstructive lung disease patients

2020 ◽  
Vol 12 (1) ◽  
pp. 1-7
Author(s):  
Baraka M ◽  
Hossam ElDessouky ◽  
Ahmed Amer Khamees ◽  
Ayman Ali Abd ElFattah ◽  
Eman Ezzat ◽  
...  
Keyword(s):  
Side Effects ◽  
Lung Disease ◽  
Bronchial Asthma ◽  
Obstructive Lung Disease ◽  
Inhaled Corticosteroids ◽  
Group I ◽  
Voice Changes ◽  
Significant Difference ◽  
Local Side ◽  
Laryngeal Examination

Background/Aims: The widespread use of inhaled corticosteroids (ICS) for the treatment of obstructive lung disease may be associated with both systemic and local side effects. These local side effects; including voice problems, oropharyngeal candidiasis, throat clearing, sense of fullness, pharyngitis, and cough, are generally viewed as minor complications of therapy in what is called steroid inhaler laryngitis (SIL). Few studies have been performed to specifically evaluate local side effects of ICS. However, they can be clinically significant, affect patient's quality of life, hinder compliance with therapy, and mask symptoms of more serious disease. The aim of this study is to examine the effect of ICS on the larynx and subsequent voice changes, and highlighting if these voice problems related to the type of inhaled corticosteroids in order to determine the importance of regular laryngeal examination in those patients. Methods: 40patients with bronchial asthma and 40 patients with COPD admitted to Chest department in Menoufia and Zagazig University Hospitals during the period from March 2017 to March 2019 were included in the study. They were divided according to the type of cortisone used into four groups; group (I): beclomethasone dipropionate (BDP) users, group (II): budesonide (BUD) users, group (III): Ciclesonide users and group (IV): fluticasone propionate (FP) users. They were evaluated as regards videolaryngoscopic examination and acoustic analysis Results: The age of the patients with bronchial asthma ranged from 29 to 42years and the age of the patients with COPD ranged from 31 to 43years. There was a statistically significant difference among the four groups of cortisone inhalation regarding laryngoscopic findings; as presence of congestion (diffuse and local), mucus spills on VF and glottis gap were all higher in frequency among the group of patients used fluticasone FP, while least signs found among ciclesonide users. Also, average pitch, Jitter, H/N ratio and MPT were more worsen in fluticasone group when compared with Ciclesonide group. Conclusion: obstructive lung disease patients may suffer from voice problems related to the type of inhaled corticosteroids that could be fade when therapy is stopped. So, regular laryngeal examination in those patients is important.

scholarly journals Ciclesonide in the Management of Asthma

2009 ◽  
Vol 1 ◽  
pp. CMT.S2133
Author(s):  
Daniel Gonzalez ◽  
Hartmut Derendorf
Keyword(s):  
Clinical Trials ◽  
Side Effects ◽  
Inhaled Corticosteroids ◽  
Parent Compound ◽  
Persistent Asthma ◽  
Hepatic Clearance ◽  
Dose Inhaler ◽  
First Line Therapy ◽  
Pharmacodynamic Profile ◽  
Metered Dose

Ciclesonide is a novel inhaled corticosteroid (ICSs) approved in most countries for the management of persistent asthma. Although inhaled corticosteroids are first-line therapy in the treatment of asthma, long term use and high-doses of these products may result in significant side effects. When developing a new ICSs, the goal is to identify a drug with comparable (or superior) efficacy to active comparators, and an improved safety profile. Ciclesonide is a prodrug which is administered through a hydrofluoroalkane-propellant metered dose inhaler (HFA-MDI). Once it reaches the lungs, the parent compound is metabolized by esterases to desisobutyryl ciclesonide (des-CIC), an active metabolite with a 100-fold greater affinity for the glucocorticoid receptor. Ciclesonide has a unique pharmacokinetic-pharmacodynamic profile which confers an improved therapeutic ratio. Several clinical trials have shown that its efficacy is superior to placebo and similar to several active comparators. However, its high pulmonary deposition and on-site activation minimizes the risk for local side effects. Also, its low oral bioavailability, high hepatic clearance, and extensive plasma protein binding, among other factors, decrease the risk for systemic side effects. Doses of ciclesonide as high as 1280 μg/day (ex-actuator) result in minimal hypothalamic-pituitary-adrenal (HPA) axis suppression, a measure commonly used to assess systemic bioavailability for an ICSs. This review will provide a summary of ciclesonide's role in the management of asthma, including a discussion of relevant clinical trials designed to evaluate its efficacy and safety.

Local side-effects of inhaled corticosteroids in asthmatic children: influence of drug, dose, age, and device

Allergy ◽  
2001 ◽  
Vol 56 (10) ◽  
pp. 944-948 ◽  
Author(s):  
J. C. Dubus ◽  
C. Marguet ◽  
A. Deschildre ◽  
L. Mely ◽  
P. Le Roux ◽  
...  
Keyword(s):  
Side Effects ◽  
Inhaled Corticosteroids ◽  
Drug Dose ◽  
Asthmatic Children ◽  
Local Side

Local Treatment of Recent Arterial Thromboembolic Occlusions with Brinase

1975 ◽  
Vol 34 (02) ◽  
pp. 498-503 ◽  
Author(s):  
D Nyman ◽  
M. A da Silva ◽  
L. K Widmer ◽  
F Duckert
Keyword(s):  
Side Effects ◽  
Local Treatment ◽  
Before And After ◽  
Local Side

SummaryBrinase was administered intra-arterially in 16 patients with thrombotic or embolic arterial occlusions. Angiography could be performed before and after treatment in 13 patients. Thrombolysis was obtained in 3 of 9 patients with thrombotic and in 3 of 4 patients with embolic occlusions. In 3 patients severe local side effects occurred.

ESTIMATION OF THE SAFETY OF LOW-INTENSITY LASER RADIATION IN TREATMENT OF PATIENTS WITH PROFESSIONAL POLYNEUROPATHIES OF THE UPPER LIMBS

2021 ◽  
Author(s):  
S.V. Grebenkov ◽  
◽  
N.Y. Malkova ◽  
O.A. Kochetova ◽  
Keyword(s):  
Laser Radiation ◽  
Side Effects ◽  
Upper Extremities ◽  
Projection Area ◽  
Outpatient Basis ◽  
Short Term ◽  
Low Intensity ◽  
Number Of Patients ◽  
Intensity Laser ◽  
Local Side

Abstract: The inclusion of low-intensity laser radiation in the complex treatment of professional polyneuropathies of the upper extremities, due to its numerous biological effects, contributes to a statistically significant reduction in pain in the hands of patients, and improves the conduction of nerve impulses along the peripheral nerves of the hands. In addition to describing the positive clinical and neurophysiological trends achieved during treatment, the issue of the safety of the developed therapy method is important. The aim of the study is to assess the safety of the proposed method of low-intensity laser therapy (LILT) in patients with professional polyneuropathies of the upper extremities. Material and methods: on the basis of the department of occupational pathology, 116 patients (60 men, 56 women) with occupational polyneuropathies of the upper extremities were treated using LILT. Therapeutic measures were carried out using a semiconductor laser apparatus for red spectrum radiation (650 nm) with fiber-optic light guides for percutaneous therapy "ALP-01-Laton" in the sitting position of patients. Diffuse scattered laser radiation of the red region of the spectrum with an energy illumination of 0.7-1.1 mW / cm2 directly affected the projection area of the exit of the median nerve from the carpal tunnel to the hand. There were 5-10 procedures per course, the energy exposure of laser radiation and the number of sessions were determined individually. Results: To ensure the safety of the therapy, patients were included in the study strictly in accordance with the developed inclusion and non-inclusion criteria. Patients were treated in a specially equipped room with the use of personal protective equipment; safety rules were followed during the operation of the device. During treatment, all 116 patients treated with LILT did not have systemic side effects. A number of patients developed short-term complaints associated with local reactions: short-term tingling sensations and "goose bumps" in the hands, warmth, slight burning sensation, etc. All recorded local side effects occurred directly during LILT-procedures and were completely stopped within 1-5 minutes after their completion. In general, LILT-exposure did not cause serious side effects and was well tolerated by patients. 13.5% of patients noted a decrease in pain in the arms directly during the LILT treatment procedures. Conclusion. The developed method of LILT of professional polyneuropathies of the upper extremities is simple and convenient for use in clinical practice: it is applicable both in a hospital and on an outpatient basis. LILT has a limited list of contraindications, and is generally well tolerated by patients with minimal local side effects.

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