Cushing Syndrome Secondary to Abuse of Dexamethasone Nasal Spray

Champion, Phillips K.

doi:10.1001/archinte.1974.00320220152022

Cited by 24 publications

(3 citation statements)

References 5 publications

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“…Topical administration of a corticosteroid such as flunisolide is thus a useful aid in the treatment of patients with perennial rhinitis. It offers greater eflicacy of corticosteroid therapy, with a lower potential for systemic activity, such as adrenal suppression seen with oral corticosteroids or some other topical corticosteroids (Champion, 1974;Michels et al, 1976;Norman et al, 1967). Careful monitoring of plasma cortisol levels revealed no evidence of adrenal suppression in any of the patients in this trial or those of others (Kammermayer et al, 1977;Turkeltaub et al, 1976) during 6 weeks of therapy.…”

Section: Discussionmentioning

confidence: 73%

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Double‐blind trial comparing flunisolide and placebo for the treatment of perennial rhinitis

Schulz¹,

Johnson²,

Freedman³

1978

Clin Experimental Allergy

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The effectiveness of a new topical steroid, flunisolide, was evaluated for the treatment of patients with perennial rhinitis. The sixty-nine patients in this 8 week double-blind parallel trial received either 300/ig/day of flunisolide or placebo. The flunisolide group showed statistically greater improvement than the placebo group in such symptoms as the duration of sneezing, stuffy nose, runny nose and nose blowing. 63% of the flunisolide group compared with 39% of the placebo group felt the test spray had provided substantial or total control of their nasal symptoms (P = 0-0026).When those patients who were skin test-positive (allergic) were considered separately from those who were skin test-negative (non-allergic), differences in responsiveness were noted. While those patients who had negative skin tests received greater relief of their symptoms with flunisolide than with placebo, patients who had positive skin tests showed a greater responsiveness to flunisolide and reported a higher incidence of significant or total control of their symptoms.Careful monitoring of plasma cortisol levels revealed no evidence of adrenal suppression in any of the patients in this trial. This lack of suppression may be due to two factors: (a) flunisolide is rapidly metabolized into a metabolite with a low degree of activity and (b) a very low dose of corticosteroid is administered.

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Section: Discussionmentioning

confidence: 73%

“…Intranasal topical corticosteroids oifer the potential of local efficacy with only minimal systemic effect. Previously developed corticosteroids were absorbed systemically in large enough amounts to cause dose-dependent pituitary-adrenal suppression (Champion, 1974;Michels, Smith & Heimlich, 1967;Norman et al, 1967).…”

Section: Introductionmentioning

confidence: 99%

Double‐blind trial comparing flunisolide and placebo for the treatment of perennial rhinitis

Schulz¹,

Johnson²,

Freedman³

1978

Clin Experimental Allergy

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“…The rate of absorption of corticosteroid ointment intraorally administered on the mucosa has not yet been determined. However, previous studies have reported the development of iatrogenic Cushing's syndrome due to the intranasal administration of dexamethasone (3,4). The rate of absorption of corticosteroid ointment intraorally administered on the mucosa may be superior to that administered percutaneously.…”

Section: Discussionmentioning

confidence: 99%

Overt Diabetes Mellitus Caused by the Topical Administration of Dexamethasone Ointment on the Oral Mucosa

et al. 2014

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We herein describe the case of a 68-year-old man who developed overt diabetes mellitus following the topical administration of dexamethasone 0.1%-containing ointment over a five-month period to treat oral lichen planus. The topical dexamethasone therapy was discontinued gradually, and the patient was subsequently treated with insulin for one month without clinical signs of overt adrenal insufficiency. An oral glucose tolerance test revealed impaired glucose tolerance after the treatment. The potential for the deterioration of glucose metabolism must be considered when patients with impaired glucose tolerance are treated with relatively low doses of topical corticosteroid ointment on the oral mucosa, even for short periods.

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Cushing Syndrome From Percutaneous Absorption of Triamcinolone Cream

May¹

1976

Arch Intern Med

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Cushing Syndrome Secondary to Abuse of Dexamethasone Nasal Spray

Cited by 24 publications

References 5 publications

Double‐blind trial comparing flunisolide and placebo for the treatment of perennial rhinitis

Double‐blind trial comparing flunisolide and placebo for the treatment of perennial rhinitis

Overt Diabetes Mellitus Caused by the Topical Administration of Dexamethasone Ointment on the Oral Mucosa

Cushing Syndrome From Percutaneous Absorption of Triamcinolone Cream

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