Inhaled corticosteroids trade names

The aim of this article is to bring less well recognised adverse effects of inhaled corticosteroids to the attention of prescribers. Whilst inhaled steroids have a more favourable side effect profile than systemic steroids, they are not free from adverse effects. The dose of inhaled steroids used should be carefully monitored, and kept at the lowest dose necessary to maintain adequate control of the patient’s disease process. Be particularly aware of the cumulative effect of co-prescribing various dose forms of corticosteroids (inhaled, intranasal, oral and topical preparations).

There is some evidence that sun exposure can accelerate steroid-induced skin atrophy, the development of which can be limited by protecting the skin, particularly the face and arms, from the sun.  Daily use of a broad-spectrum sunscreen (UVB and UVA block) and appropriate protective clothing is recommended. 10 , 12 - 14   Patients on corticosteroids should also be encouraged to regularly use moisturisers on their arms and legs, as these may reduce bruising and tearing of the skin from minor trauma. 11   Evidence suggests that topical tretinoin can increase the epidermal thickness of sun-damaged atrophic skin, but long-term use may be necessary. 14   In dermatological practice, topical retinoids are used to help reverse skin atrophy caused by sun exposure or corticosteroid use.

Oral and injectable systemic corticosterois are steroid hormones prescribed to decrease inflammation in diseases and conditions such as arthritis (rheumatoid arthritis, for example), ulcerative colitis, Crohn's disease, asthma, bronchitis, some skin rashes, and allergic or inflammatory conditions that involve the nose and eyes. Examples of systemic corticosteroids include hydrocortisone (Cortef), cortisone, prednisone (Prednisone Intensol), prednisolone (Orapred, Prelone), and methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol). Some of the side effects of systemic corticosteroids are swelling of the legs, hypertension, headache, easy bruising, facial hair growth, diabetes, cataracts, and puffiness of the face.

Another common fear about corticosteroids is that they will cause growth suppression in children. To date, many studies have been done that prove that corticosteroids do not stunt a child's growth. Six years of ongoing studies in children and adolescents who used inhaled corticosteroids show that the speed of growth may be slowed by about 1 cm. over one year in children. However, these children catch up and do attain their full adult height. In some studies, these children grew even taller than their siblings. Interestingly, poorly controlled asthma can actually contribute to growth suppression.

Use of QVAR with a spacer device in children less than 5 years of age is not recommended. In vitro dose characterization studies were performed with QVAR 40 mcg/actuation with the OptiChamber and AeroChamber Plus ® spacer utilizing inspiratory flows representative of children under 5 years old. These studies indicated that the amount of medication delivered through the spacing device decreased rapidly with increasing wait times of 5 to 10 seconds as shown in Table 2. If QVAR is used with a spacer device, it is important to inhale immediately.

Inhaled corticosteroids trade names

inhaled corticosteroids trade names

Another common fear about corticosteroids is that they will cause growth suppression in children. To date, many studies have been done that prove that corticosteroids do not stunt a child's growth. Six years of ongoing studies in children and adolescents who used inhaled corticosteroids show that the speed of growth may be slowed by about 1 cm. over one year in children. However, these children catch up and do attain their full adult height. In some studies, these children grew even taller than their siblings. Interestingly, poorly controlled asthma can actually contribute to growth suppression.

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