Adverse effects of inhaled corticosteroids

Maxwell, DL

doi:10.1016/0753-3322(90)90047-d

Cited by 20 publications

(17 citation statements)

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“…However, long-term use of inhaled corticosteroids, especially at higher doses, has been accompanied by concern about systemic complications as well as local adverse events2. Systemic complications of high dose inhaled steroids include osteoporosis, adrenocortical suppression, skin thinning, cataract, glaucoma and others3. Local adverse events include throat pain or sore throat, dysphonia, oral candidiasis, and others4.…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Immediate Diet for Reducing Local Adverse Events of Inhaled Corticosteroid: A Pilot Study

Lee

Yong

et al. 2012

Tuberc Respir Dis

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BackgroundLocal adverse events associated with inhaled corticosteroid use, including dysphonia, pharyngitis and oral candidiasis, can affect adherence for treatment. 'Mouth rinsing method' has been used for reducing local adverse events, but it cannot ensure complete prevention. The goal of this pilot study was to identify whether the 'immediate diet method' can reduce local adverse events in a limited number of patients.MethodsThe study was conducted in a total of 98 patients, who had been prescribed a medium-dose fluticasone propionate for the first time, from January to October in 2010. One training nurse had performed the education on how to use the inhaler, including the mouth rinsing method. And with follow-ups at one month intervals, any patient who experienced such adverse events were educated on the immediate diet method, having a meal within 5 minutes after using an inhaler and they were checked on any incurrence of adverse events with one month intervals for 2 months.ResultsThe mean age of patients was 65.9 years old. The local adverse events had incurred from 18.4% of the study subjects. When performed the follow-up observation in 18 patients with local adverse events after education on the immediate diet method, 14 patients (77.8%) had shown symptomatic improvements. Three of 4 patients did not show any improvement, in spite of implementing the immediate diet method. The other 1 patient did not practice the immediate diet method properly.ConclusionThe immediate diet method may be useful in reducing the local adverse events, caused by the use of inhaled corticosteroid.

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Section: Introductionmentioning

confidence: 99%

The Efficacy of Immediate Diet for Reducing Local Adverse Events of Inhaled Corticosteroid: A Pilot Study

Lee

Yong

et al. 2012

Tuberc Respir Dis

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“…Oral candidosis has been described as one of the side effects of the therapy with inhaled corticosteroids 4,12,19,23 , which have anti-inflammatory properties and are often used for the symptomatic treatment of asthma in adults and children 5,23,24 . The incidence of oropharyngeal candidosis in patients treated with inhaled corticosteroids varies between 0 and 77%, mainly because of the different diagnosis criteria used 4,22,27 .…”

Section: Introductionmentioning

confidence: 99%

“…Studies on the deposition of corticosteroid sprays on the tissues revealed that approximately 10% of the inhaled medicine remains in the lungs. The remaining percentage is deposited on the oropharyngeal mucosa, where the drug can cause many effects before being absorbed 12 . The local side effects of inhaled corticosteroids, besides oropharyngeal candidosis, include cough, hoarseness, dysphonia and perioral dermatitis 2,4 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of yeasts in the oral cavity of children treated with inhaled corticosteroids

et al. 2004

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The aim of this study was to observe the prevalence of Candida spp. in the oral cavity of children undergoing treatment with inhaled corticosteroids. Thirty children treated with inhaled corticosteroids and thirty control children were studied. Saliva samples were collected through oral rinses with phosphate buffered saline (PBS). The samples were plated on Sabouraud's dextrose agar and incubated at 37 degrees C for 48 h. After this period, the number of colony-forming units per ml (cfu/ml) of saliva was calculated. The isolates were identified by phenotypic characterization. Candida spp. was isolated from 43.33% of the samples of children treated with corticosteroids, with a mean of 780 cfu/ml of saliva, and from 30% of the samples of the control group, with a mean of 560 cfu/ml of saliva. No significant statistical difference was observed between the groups. C. albicans was the prevalent species in both groups, followed by C. guilliermondii, C. parapsilosis and C. stellatoidea. Furthermore, Rhodotorula rubra and C. lusitaniae were also isolated from the treated group. We concluded that there was no significant increase in the prevalence and number of Candida spp. in the oral cavity of children treated with inhaled corticosteroids.

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“…[5][6][7] We previously confirmed that mouth washing after inhalation is effective for removal of drug residues. 3,4) However, the removal of drug residues by mouth washing and number of times required were different between easily removed and difficult to remove areas, thus we constructed a compartment model and conducted analyses with it.…”

Section: Discussionmentioning

confidence: 90%

Kinetic Analysis of Effects of Mouth Washing on Removal of Drug Residues Following Inhalation of Fluticasone Propionate Dry Powder

Yokoyama

Yamamura

Ozeki

et al. 2007

Biological & Pharmaceutical Bulletin

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Inhaled corticosteroids are widely used for treatment of asthma, though local adverse effects, such as candidiasis and hoarseness, are often seen in patients treated with those drugs. Therefore, the Packaging Inserts enclosed with such medications recommend mouth washing after inhalation for prevention of local adverse effects. In spite of that recommendation, candidiasis has been reported by patients who washed their mouth after inhalation.1) Therefore, we carried out a series of studies to investigate the influence of different methods of mouth washing on the removal rates of inhaled corticosteroids. More than 90% of the drug was recovered by washing mouth twice, when the mouth washing procedure was gargling and rinsing for 5 s each.2) However, since no significant differences were observed among 3 methods tested in a previous study, we could not conclude which was most effective. On the other hand, a relationship was observed between the amount of drug residue removed by mouth washing and the number of times of mouth washing was employed in 2 phases. 3,4)Based on those results, we speculated that drug residue remained in different amounts in easy and difficult to remove areas following mouth washing. In the present study, we investigated the differences in removal efficiency of drug residues from both easy and difficult to remove areas using 3 different methods of mouth washing; gargling and rinsing in combination, rinsing alone, and gargling alone, using a compartment model. MATERIALS AND METHODS Compartment Model for Analysis of Removal Efficiency of Drug Residues by Mouth WashingFlutide ® (FP-DPI) 50, 100, and 200 Rotadisk ® dosages were used in the present study. In addition, we employed our previously reported experimental data in the analysis, in which 3 healthy volunteers (2 males, 1 female; mean age 38.3Ϯ9.3 years old, range 28-45 years) participated.3) In the present experiment, mouth washing was started immediately following sprinkling directly in the mouth or inhalation of 1 blister, and consisted of gargling and rinsing with water for 5 s each, then the procedures were repeated 5 times. The total volume of water used for each mouth washing was 100 ml, which was divided into 5 aliquots of 20 ml each. We also developed a compartment model, in which inhaled FP-DPI residue was distributed into 2 different areas, one from which the drug was easily removed and the other from which it was difficult to remove by mouth washing. The equations used for the model were as follows:In those, X 1 and X 2 represent the amount of drugs in areas from which drugs are easily removed and difficult to remove, respectively. X 0 , F, T, and n represent the medication dose, ratio of amount of dose removed by mouth washing to medication dose, ratio of amount of dose removed from the difficult to remove area by mouth washing to total amount of dose removed by mouth washing, and the number of times of mouth washing, respectively. Further, k 1 and k 2 represent the constants of removal efficiency of X 1 and X 2 , respectively....

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Adverse effects of inhaled corticosteroids

Cited by 20 publications

References 50 publications

The Efficacy of Immediate Diet for Reducing Local Adverse Events of Inhaled Corticosteroid: A Pilot Study

The Efficacy of Immediate Diet for Reducing Local Adverse Events of Inhaled Corticosteroid: A Pilot Study

Prevalence of yeasts in the oral cavity of children treated with inhaled corticosteroids

Kinetic Analysis of Effects of Mouth Washing on Removal of Drug Residues Following Inhalation of Fluticasone Propionate Dry Powder

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