Inhaled corticosteroids in asthma
Inhaled corticosteroids are recommended for prophylactic treatment of bronchial asthma if
1. Patients are using a beta2 agonist more than 3 times a week
2. If symptoms disturb sleep more than once a week
3. Patient has suffered exacerbations in the last 2 years requiring a systemic corticosteroid or a nebulised bronchodilator.
Beclometasone dipropionate (beclomethasone dipropionate), budesonide and fluticasone propionate are common inhaled corticosteroids.
Inhaled corticosteroids have considerably fewer systemic side effects than oral corticosteroids.
Cfc-Free Inhalers
Chlorofluorocarbon (CFC) propellants in pressurised aerosol inhalers are being replaced by hydrofluoroalkane (HFA) propellants. Patients receiving CFC-free inhalers should be reassured about the efficacy of the new inhalers and the aerosol may feel and taste different.
CANDIDIASIS
Candidiasis is reported site effect after inhaled corticosteroids in asthma. It can be reduced by using spacer. Candidiasis responds to antifungal lozenges without discontinuation of therapy—rinsing the mouth with water (or cleaning child’s teeth) after inhalation of a dose may also be helpful.