Revisited: Aerosol Corticosteroids in the Treatment of Childhood Asthma

PEDIATRICS ◽  
1983 ◽  
Vol 72 (1) ◽  
pp. 130-131
Author(s):  
GARY S. RACHELEFSKY ◽  
SHELDON C. SIEGEL
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Corticosteroid Therapy ◽  
Childhood Asthma ◽  
Treatment Modality ◽  
Duration Of Therapy ◽  
Systemic Corticosteroids ◽  
Inappropriate Treatment ◽  
Systemic Side Effects ◽  
The 1950S

Systemic corticosteroids were introduced in the 1950s for the treatment of asthma. Usually, excellent results were obtained although a number of side effects became apparent. Prolonged use of corticosteroid therapy for asthma remains quite controversial, and it is often regarded as an inappropriate treatment modality. Inasmuch as complications from corticosteroids are largely dependent on dose and duration of therapy, it was reasoned that by topically administering the corticosteroids, the amount of drug necessary to control symptoms would be reduced and, in turn, lessen the number of adverse effects. Initially developed corticosteroid aerosols produced variable effectiveness with associated systemic side effects.1

The Use and Abuse of Topical Corticosteroids

1977 ◽  
Vol 63 (1) ◽  
pp. 18-25
Author(s):  
M. D. Catterall
Keyword(s):  
Side Effects ◽  
Topical Corticosteroid ◽  
Corticosteroid Therapy ◽  
Rank Order ◽  
Topical Corticosteroids ◽  
Systemic Side Effects

AbstractA rationalised approach to topical corticosteroid therapy is presented. Factors which influence the choice of preparation are considered, based upon the concept of ’rank order ’, for both halogenated and non-halogenated steroids. Practical considerations, including choice of base, polythene occlusion and tachyphylaxis are discussed and local and systemic side effects considered in detail.

scholarly journals Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports

2020 ◽  
Author(s):  
Guiomar Pinheiro ◽  
Ana Rita Costa ◽  
Ana Campar ◽  
Teresa Mendonça
Keyword(s):  
Side Effects ◽  
Partial Response ◽  
Adverse Effects ◽  
Large Scale ◽  
Case Reports ◽  
Immunosuppressive Drugs ◽  
Systemic Corticosteroids ◽  
First Case ◽  
Symptom Relapse

Fasciitis with eosinophilia (FE) is a rare connective tissue disease. Due to its rarity, large-scale studies are lacking, which makes its treatment challenging. Systemic corticosteroids (SCSs) are the cornerstone of treatment; however, additional immunosuppressive drugs (ISDs) are frequently necessary (usually methotrexate). We report 2 patients, for whom an SCS and methotrexate were not a viable long-term option. In the first case, we were unable to taper the SCS dose without symptom relapse, the patient showed only a partial response to methotrexate and presented side effects. The second case never fully responded to the SCS and methotrexate and demonstrated serious SCS adverse effects. Both patients were started on tocilizumab with extremely favourable results, making this drug a potential therapeutic weapon for these patients.

scholarly journals Severe Corticosteroid-Induced Ocular Hypertension Requiring Bilateral Trabeculectomies in a Patient with Takayasu’s Arteritis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Anna Maria Gruener ◽  
Pranev Sharma ◽  
Sally Ameen ◽  
Faisal Ahmed
Keyword(s):  
Side Effects ◽  
Ocular Hypertension ◽  
Inflammatory Diseases ◽  
Takayasu’S Arteritis ◽  
Takayasu's Arteritis ◽  
Ocular Side ◽  
Systemic Corticosteroids ◽  
Asymptomatic Patients ◽  
Autoimmune And Inflammatory Diseases ◽  
Systemic Side Effects

We present a rare case of severe corticosteroid-induced ocular hypertension (OHT) after prolonged systemic corticosteroid use in a young woman with Takayasu’s arteritis. As she did not sufficiently respond to ocular antihypertensive therapies, bilateral enhanced trabeculectomies were required to normalize her intraocular pressures. The systemic side effects of corticosteroids are well known, yet steroid-induced OHT and glaucoma remain silent causes of ocular morbidity. This case highlights the importance of IOP-monitoring in visually asymptomatic patients on systemic corticosteroids. It further emphasizes the need to raise awareness of the potential ocular side effects of steroids amongst physicians, in particular those looking after patients with autoimmune and inflammatory diseases.

scholarly journals Corticosteroids: Review of the History, the Effectiveness, and Adverse Effects in the Treatment of Joint Pain

2021 ◽  
Vol S1;24 (1;S1) ◽  
pp. S233-S246
Keyword(s):  
Articular Cartilage ◽  
Side Effects ◽  
Adverse Effects ◽  
Immune Function ◽  
Joint Pain ◽  
Current Evidence ◽  
Review Of The Literature ◽  
Short Term ◽  
Increased Risk ◽  
Systemic Side Effects

BACKGROUND: Corticosteroids have been used for the past 70 years in the treatment of various musculoskeletal conditions. This includes its use for joint pain such as rheumatoid arthritis and osteoarthritis. OBJECTIVES: A narrative review of the literature from its initial discovery to the present day to summarize the research of corticosteroids for joint pain to determine the safety and effectiveness of this commonly used and prescribed medication. METHODS: A review of the literature was performed regarding the effectiveness and side effects of corticosteroids for joint and osteoarthritis conditions. RESULTS: The current evidence would suggest that the use of corticosteroids provides moderate short-term benefit for reducing pain and improving functioning. These benefits generally last several weeks without long-term effectiveness. In addition to its limited short-term effectiveness, there are multiple potential adverse effects including toxicity to articular cartilage and numerous systemic side effects such as increases in blood glucose levels, a reduction in immune function, and an increased risk of infections. LIMITATIONS: English only articles were reviewed. No attempt was made to perform a formal statistical or meta-analysis. CONCLUSIONS: The current evidence would suggest that the use of corticosteroids provides moderate evidence for short-term pain reduction and improvement in function. There are multiple potential adverse effects, such as toxic damage to articular cartilage, as well as numerous systemic side effects, including a reduction in immune function and an increased risk of infection, of which physicians need to be aware. KEY WORDS: Cortisone, corticosteroids, arthritis, joint, pain, adverse effects, immune function, infections

Inhaled Glucocorticoids in Rhinosinusitis: A Few Pharmacological Aspects, We Must Know

2010 ◽  
Vol 3 (3) ◽  
pp. 129-130
Author(s):  
JS Thakur ◽  
NK Mohindroo ◽  
DR Sharma ◽  
Anamika Thakur
Keyword(s):  
Allergic Rhinitis ◽  
Side Effects ◽  
Adverse Effects ◽  
Inhalation Therapy ◽  
Perennial Allergic Rhinitis ◽  
Systemic Side Effects ◽  
Low Incidence ◽  
Therapeutic Doses ◽  
Inhaled Glucocorticoids

Abstract Inhaled glucocorticoids are very effective for the management of seasonal and perennial allergic rhinitis. Various glucocorticoids are available for inhalation therapy with varying affinity for the receptors. Inhaled glucocorticoids have very low incidence of systemic side effects at the usual therapeutic doses. In this review we have discussed the pharmacokinetics, pharmacodynamics and adverse effects profile of the commonly available inhaled glucocorticoids.

Adverse side-effects after topical fluorinated corticosteroid therapy

1973 ◽  
Vol 108 (1) ◽  
pp. 132-133 ◽  
Author(s):  
M. E. Chernosky
Keyword(s):  
Side Effects ◽  
Corticosteroid Therapy ◽  
Adverse Side Effects

Critical Review on Standard Operative Procedure of Yapana Basti Karma

2018 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Rishu Sharma ◽  
Dr. Gyanendra Datta Shukla ◽  
Dr. Alok Kumar Srivastava
Keyword(s):  
Side Effects ◽  
Critical Review ◽  
Treatment Modality ◽  
Operative Procedure ◽  
The Body ◽  
Dosage Schedule ◽  
Dual Function ◽  
Time Period ◽  
Curative Action

Panchakarma therapy is one of the vital branch of Ayurveda, which deals mainly with purification of the provoked Doshas from the body. Basti Chikitsa is regarded as the prime treatment modality among the Panchakarma. It is having not only curative action but also preventive and promotive actions. It is considered as best treatment for Vata Dosha. Yapana Basti is a subtype of Asthapana Basti, which is having the property to support life and promote longevity and widely used in various disorders. Rajayapana Basti is superior amongst all the Yapana Bastis described by Acharya Charaka as it is the king of Yapana. This Rasayana Yapana Basti performs dual function of both Anuvasana and Niruha; hence this is Srotoshodhaka and Brimhana at the sametime. That’s why there is no need to administer separate Anuvasana while giving Yapana Basti. There is an urgent need of standardizing the classical Panchakarma procedures in consideration of the need of today. The dosage schedule, exact procedures, medicaments, effects, and side effects are to be standardized so that uniform procedure of practice should be followed all over nation. Standardization is the need of hour for physicians, to prevent Atiyoga (over activity), Ayoga (less or no activity) and to get adequate effects in a systematic and sophisticated manner within desired time period.

scholarly journals Recent advances in understanding NRF2 as a druggable target: development of pro-electrophilic and non-covalent NRF2 activators to overcome systemic side effects of electrophilic drugs like dimethyl fumarate

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 2138 ◽  
Author(s):  
Takumi Satoh ◽  
Stuart Lipton
Keyword(s):  
Side Effects ◽  
Specific Interaction ◽  
Dimethyl Fumarate ◽  
Carnosic Acid ◽  
European Medicines Agency ◽  
Related Factor ◽  
Inflammatory Phase ◽  
First Case ◽  
Systemic Side Effects ◽  
Transcriptional Pathway

Dimethyl fumarate (DMF) is an electrophilic compound previously called BG-12 and marketed under the name Tecfidera®. It was approved in 2013 by the US Food and Drug Administration and the European Medicines Agency for the treatment of relapsing multiple sclerosis. One mechanism of action of DMF is stimulation of the nuclear factor erythroid 2-related factor 2 (NRF2) transcriptional pathway that induces anti-oxidant and anti-inflammatory phase II enzymes to prevent chronic neurodegeneration. However, electrophiles such as DMF also produce severe systemic side effects, in part due to non-specific S-alkylation of cysteine thiols and resulting depletion of glutathione. This mini-review presents the present status and future strategy for NRF2 activators designed to avoid these side effects. Two modes of chemical reaction leading to NRF2 activation are considered here. The first mode is S-alkylation (covalent reaction) of thiols in Kelch-like ECH-associated protein 1 (KEAP1), which interacts with NRF2. The second mechanism involves non-covalent pharmacological inhibition of protein-protein interactions, in particular domain-specific interaction between NRF2 and KEAP1 or other repressor proteins involved in this transcriptional pathway. There have been significant advances in drug development using both of these mechanisms that can potentially avoid the systemic side effects of electrophilic compounds. In the first case concerning covalent reaction with KEAP1, monomethyl fumarate and monoethyl fumarate appear to represent safer derivatives of DMF. In a second approach, pro-electrophilic drugs, such as carnosic acid from the herb Rosmarinus officinalis, can be used as a safe pro-drug of an electrophilic compound. Concerning non-covalent activation of NRF2, drugs are being developed that interfere with the direct interaction of KEAP1-NRF2 or inhibit BTB domain and CNC homolog 1 (BACH1), which is a transcriptional repressor of the promoter where NRF2 binds.

The Use of Methotrexate in Rheumatoid Arthritis

1985 ◽  
Vol 19 (5) ◽  
pp. 349-358 ◽  
Author(s):  
Peter W. Letendre ◽  
Douglas J. DeJong ◽  
Donald R. Miller
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trials ◽  
Folic Acid ◽  
Side Effects ◽  
Adverse Effects ◽  
Systemic Administration ◽  
Refractory Disease ◽  
Controlled Clinical Trials ◽  
Folic Acid Antagonist ◽  
Acid Antagonist

The use of methotrexate in rheumatoid arthritis is reviewed. Methotrexate, a folic acid antagonist, is sometimes employed in an attempt to symptomatically control patients whose disease does not respond adequately to conventional therapies. Systemic administration of 7.5–15 mg/wk in a “pulse” fashion appears to be effective without precipitating severe adverse effects. However, concern over potentially serious side effects and a lack of well-controlled clinical trials have limited its use to severe, refractory disease. Further studies are needed before its role in rheumatoid arthritis can justifiably be expanded.

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