Effectiveness and complications of aerosol dexamethasone phosphate in severe asthma

Dennis, Macey; Itkin, Irving H.

doi:10.1016/0021-8707(64)90051-6

Cited by 32 publications

(9 citation statements)

References 11 publications

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“…Earlier studies in humans have shown that inhaled dexamethasone sodium phosphate was more effective than dry powder inhalers or MDI containing budesonide or fluticasone for cough control [4] and helped reduce the dose of systemic corticosteroids in severe asthmatics [5,6]. Improvement in the clinical status of asthmatic children was also noted following the administration of dexamethasone phosphate disodium via MDI [7,8].…”

Section: Introductionmentioning

confidence: 99%

Nebulisation of dexamethasone sodium phosphate for the treatment of severe asthmatic horses

Mainguy-Seers

Bessonnat

Picotte

et al. 2019

Equine Veterinary Journal

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Summary Background Inhaled corticosteroids are effective in the treatment of equine asthma. A recent study reported that nebulisation of injectable dexamethasone had low systemic bioavailability in healthy horses and could represent a cost‐effective therapy for equine inflammatory lung diseases. Objectives To determine the effects of dexamethasone nebulisation on lung function in severe asthmatic horses. It was hypothesised that dexamethasone administered by nebulisation would be more effective than the same dose administered orally. Study design Randomised blinded experimental study in severe asthmatic horses. Methods Twelve severe asthmatic horses in clinical exacerbation were randomly assigned to treatment with 5 mg of dexamethasone sodium phosphate by nebulisation (n = 6) or by oral administration (n = 6), once daily for 7 days. Lung function was evaluated at baseline, after four treatment days (D4) and 24 h after the last dose (D8). The presence of residual bronchospasm was assessed on D8 with N‐butylscopolammonium bromide administration (0.3 mg/kg i.v.). A respiratory clinical score was performed daily. Serum cortisol concentration was measured at baseline, D4 and D8. Results The pulmonary elastance was unchanged in both groups while pulmonary resistance was significantly improved in the oral group on D8 (mean reduction in 1 cm H2O/L/s [CI: 0.34–1.65, P = 0.003]). All horses had residual bronchospasm at the end of the study. There was a group difference in the respiratory clinical score as it was significantly reduced in the oral group, from D5 to D8. Serum cortisol concentration decreased in all subjects. Main limitations Low number of horses and lack of placebo group. Conclusions Considering the lack of improvement of lung function and the hypothalamic‐pituitary‐adrenal axis suppression, the results of this study do not support aerosolisation of an injectable form of dexamethasone for the treatment of severe equine asthma at the dose and with the nebuliser evaluated.

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Section: Introductionmentioning

confidence: 99%

Nebulisation of dexamethasone sodium phosphate for the treatment of severe asthmatic horses

Mainguy-Seers

Bessonnat

Picotte

et al. 2019

Equine Veterinary Journal

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“…Once inside the nucleus, the GC/GR complex functions by regulating up to 20 % of genes expressed by immune cells. Specifically, GCs act by trans-repressing inflammatory genes and stimulating the transcription of anti-inflammatory genes leading to reduced activation, recruitment and survival of inflammatory and epithelial cells [ 1 , 11 , 12 ]. Glucocorticoids may also regulate the immunomodulatory function of smooth muscle cells and affect airway remodeling in asthma [ 13 ].…”

Section: Mechanisms Of Action Of Glucocorticoidsmentioning

confidence: 99%

Why do some asthma patients respond poorly to glucocorticoid therapy?

Henderson

Caiazzo

McSharry

et al. 2020

Pharmacological Research

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“…1,36 These drugs can lower host resistance to infection and predispose individuals to systemic and superficial candidiasis. 1 Dennis and Itkin 64 were the first to draw attention to the relationship between steroid inhalers and oral candidiasis. The synthetic steroids, beclomethasone dipropionate, betamethasone valerate, sodium cromoglycate and triamcinolone acetonide, used to treat asthma, are also associated with oral and pharyngeal candidiasis.…”

Section: Corticosteroid Therapymentioning

confidence: 99%

Host factors affecting oral candidiasis

Wyk

Steenkamp

2011

Southern African Journal of Epidemiology and Infection

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Review: Host factors affecting oral candidiasis Candida species are responsible for a wide range of systemic as well as superficial opportunistic infections, which are of particular importance among debilitated and immunocompromised patients. Species of the genus Candida comprise part of the oral commensal microflora of healthy individuals, with Candida albicans being the most common pathogen of the genus. A diverse array of host factors has been implicated in the pathogenesis of oral candidiasis. This paper describes the local, systemic and iatrogenic factors affecting oral candidiasis.Peer reviewed.

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Effectiveness and complications of aerosol dexamethasone phosphate in severe asthma

Cited by 32 publications

References 11 publications

Nebulisation of dexamethasone sodium phosphate for the treatment of severe asthmatic horses

Nebulisation of dexamethasone sodium phosphate for the treatment of severe asthmatic horses

Why do some asthma patients respond poorly to glucocorticoid therapy?

Host factors affecting oral candidiasis

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