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Corticosteroids – How it Works? – Side Effects of Use

28 May 2007

Written by: steve Posted under Inhalants

Corticosteroids Drug – How does Corticosteroids Works?

Type of Drug:

Respiratory inhalants; drugs that produce an anti-inflammatory effect in lungs of stable asthma patients; asthma controllers; asthma preventatives.

How the Drug Works:

Irritation and inflammation (swelling) of the bronchial tubes (air tubes) of the lung is frequently a cause of persistent or recurrent asthma symptoms. These synthetic “anti-inflammatory steroids” decrease the irritation and swelling (inflammation) of the air tubes of the lungs and control or prevent asthma symptoms. These drugs do not directly open tho bronchial tubes and do not provide rapid relief. They are useful for controlling or preventing asthma symptoms but do not help during an acute asthma attack . When in to the bronchial tubes, the effect is local and the incidence of these of side effect is very low when compared to sideffect when the medications are given by mouth.

Uses:

To prevent or reduce the frequency and severity of bronchial asthma attacks in patients requiring chronic (long-term) treatment.

Corticosteroid inhalants are not to be used to treat an acute asthma attack or in the treatment of non asthmatic bronchitis.

Flovent Rotadisk – For treatment of chronic asthma attacks in patients 4 years of age and older or for asthma requiring long-term corticosteroid therapy.

Patients using corticosteroid inhalants may also take oral corticosteroid therapy or specific bronchodilator therapy.

Precautions:

Changing from other dosage forms: Patients who have been on long-term oral corticosteroids may lose their body’s natural ability to produce corticosteroid hormones. Switching or lessening current oral doses may cause symptoms of withdrawal (eg, joint or muscle pain, tiredness, depression). Therefore, taper dosage of oral steroid gradually and only with the instruction of a doctor.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if inhaled corticosteroids appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: There is insufficient information available to warrant use in children younger than 12 months of age (budesonide suspension), younger 1Mn 6 years of age (beclomethasone, budesonide inhalation powder, flunisolide, and triamcinolone) or younger than 12 years of age (fluticasine aeroseol). Extend regular use may suppress growth in children and teenagers.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over-Âthe-counter or prescription medications or dietary supplements with inhaled corticosteroids. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. Ketoconazole (eg, Nizoral) interacts with inhaled corticosteroids.

Side Effects:

Every drug is capable of producing side effects. Many inhaled corticosteroid users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Diarrhea; toothache; nausea; vomiting; stomach pain or upset; constipation; gas; oral thrush (white patches in mouth); heartÂburn; indigestion; changes in appetite.

Nervous System: Headache; migraine; fatigue; dizziness; irritability; sleeplessness; fainting; shakiness; nervousness; mental disturbances; depression; agitation; lightheadedness; anxiety; changes in energy level; moodiness; numbness; vertigo (feeling of whirling motion); emotional liability.

Respiratory System: Sore throat; flu-like symptoms; head, nasal, or chest congestion; dry or irritated mouth, nose, or throat; hoarseness; voice changes; mouth infections; coughing; wheezing; difficulty breathing; runny nose; sneezing; throat infection; upper respiratory tract infection; loss of voice; nosebleed; sinus inflammation; chest tightness; phlegm; chest tightness; worsening of asthma.

Skin: Acne; red, itchy skin; rash; itching; hives; bruising; skin discoloration; sensitivity to sunlight.

Other: Fever; urinary tract or vaginal infections; neck pain; back problems; pain; weight gain; unpleasant taste and smell; blurred vision; eye discomfort; speech problems; high blood pressure; rapid heartbeat; ear or eye infection; loss of sense of taste and smell; menstrual problems; bone fracture; palpitations (pounding in the chest); chest pain; suppression of HPA function; weakness; pain; back pain; enlarged lymph nodes; general body discomfort; sweating; swelling of the arms or legs; muscle or joint pain; chills; fever .

Guidelines for Use:

Read and follow patient instructions provided with the product.
Use exactly as prescribed. Do not increase recommended dose. Benefits are not immediate and effectiveness requires regular use. Contact your doctor if symptoms do not improve or condition worsens.
Aerosol- Using the inhaler beyond the labeled number of actuations (puffs) will result in ineffective doses of medication and loss of control of asthma. Canisters should only be used with their actuator (plastic holder) Administering with a spacing device (eg, Optihaler, Aercochamber) will enhance medications delivery and effectiveness.

Qvar Prime the aerosol canister before using the first time or if it has not been used for 10 or more days. Activating the aerosol into the air 2 times will prime the canister.
Inhalation suspension – Must be administered by air-driven jet nebulizer. Shake gently before adding to nebulizer canister.
Do not stop using when you feel better, unless advised by your doctor. These medicines are designed to prevent asthma symptoms and must be used on a daily basis, even when you feel well.
Rinse mouth thoroughly, without swallowing, after completing inhalations. This reduces the risk of mouth infection.
Do not use for an acute asthma attack requiring rapid relief. Inhaled corticosteroids are not bronchodilators.
Avoid spraying in eyes.
Bronchodilator inhaler use – Use the bronchodilator (eg, isoproterenol, albuterol, epinephrine) several minutes before the corticosteroid aerosol. This opens the air tubes and increases penetration of the steroid into the passageways.
Notify your doctor if you experience oral thrush (white patches in mouth or throat), voice changes, sore throat, sore mouth, mental disturbances, increased bruising, weight gain, cushingoid features, acne, or cataracts.
Contact your doctor when asthma attacks do not adequately respond to bronchodilators or if you notice a sudden increase in the need for your bronchodilator. Oral or injectable steroids may be required.
May cause dizziness or lightheadedness. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
May cause photosensitivity (sensitivity to sunlight). Avoid prolonged exposure to the sun and other ultraviolet (UV) light (eg, tanning beds). Use sunscreens and wear protective clothing until tolerance is determined.
Supplementary oral steroids may be necessary during periods of high stress such as surgery, trauma, infection, or severe asthma attack. Carry a warning card indicating this potential need.
Notify your doctor immediately if symptoms of steroid withdrawal occur when changing from oral to inhalant therapy (eg, joint or muscle pain, lack of energy, depression, more problems breathing, wheezing, dizziness). Your doctor may increase your oral steroid dose temporarily and then begin decreasing the oral steroid dose more slowly.
Allergic reactions (eg, rash, hives, difficulty breathing) have occurred following beclomethasone use. These may be immediate or delayed. Contact your doctor if you suspect a reaction .
Avoid exposure to chicken pox, measles, or other infections involving the respiratory tract. If exposed, consult your doctor immediately.
Store at room temperature. Use inhalation suspension within 2 weeks of opening foil pouch. Use fluticasone powder within 2 months of open. Use fluticasone salmeterol powder within 1 month of opening foil pouch