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Side Effects With Inhaled Corticosteroids: Systemic Side Effects in Children
Oral corticosteroids are a known risk factor for the development of subcapsular cataracts, with risk influenced by daily cumulative dose, age, and ethnic origin. The systematic review described above concluded that the risk of cataracts due to ICS was small and may only be relevant in elderly patients. Two studies not included in the systematic […]
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Side Effects With Inhaled Corticosteroids: Risk of Systemic Side Effects
While safety data have been reported for many clinical trials, there are few studies that have been adequately powered, or have long enough follow-up periods, to assess long-term systemic side effects with ICS. A systematic review conducted in collaboration between the American College of Chest Physicians, the American Academy of Allergy, Asthma, and Immunology, and […]
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Side Effects With Inhaled Corticosteroids: Asthma Clinical Research
Modern delivery systems, such as HFA-based pMDI inhalers, enhance drug targeting to the lungs. Thus, lower ICS doses can be used, such that the clinical response is maintained but systemic exposure reduced. For example, conversion from CFC to HFA as a propellant moved the dose-response curve for drugs delivered using the HFA device toward the […]
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Side Effects With Inhaled Corticosteroids: Systemic Side Effects With ICS Therapy Systemic Availability of ICS
ICS absorption into the systemic circulation occurs either through the lungs or by swallowing drug that is not inhaled but deposited at the back of the throat. Nevertheless, other factors need to be considered and these are discussed below. The contribution of GI absorption to systemic ICS exposure is minimal compared with that of absorption […]
Side Effects With Inhaled Corticosteroids: HFA
Inhaler device can also influence the occurrence of local side effects, mainly through determining the relative amount of drug deposited in the lungs vs the oropharynx. Ideally, a device should maximize the proportion of drug that reaches the lung; higher lung deposition reduces the required dose, and lower oropharyngeal deposition reduces the potential for oropharyngeal […]
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Side Effects With Inhaled Corticosteroids: Local Side Effects in Children
Similar findings for local side effects are seen for ICS/long-acting (3-agonist combination therapies. With BUD/formoterol, pharyngitis was seen in 6% of patients in clinical trials, with coughing in 5%. For FP/salmeterol, oropharyngeal candidiasis was seen in 2 to 4% of patients, hoarseness/dysphonia in 2 to 4%, throat irritation in 1 to 3%, and cough/breathing difficulties […]
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Side Effects With Inhaled Corticosteroids: Systematic Review
The authors also showed that immediately after inhalation of 200 ^g of FP, there were significant amounts of FP in the esophagus (3.3 ^g). Even after 30 min, FP remained detectable and the amount of drug recovered was affected by whether the patient was prone or remained upright (0.67 ^g if the patient laid down […]
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