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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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Side Effects With Inhaled Corticosteroids: Local Side Effects of ICS Therapy
A systematic review compared the dose response for oral candidiasis for FP with the dose response for preventing an exacerbation. The authors calculated the number of patients that needed to be treated to prevent withdrawal of therapy due to worsening of asthma symptoms vs the risk of oral candidiasis. In this analysis, the number of […]
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Side Effects With Inhaled Corticosteroids
Inhaled corticosteroids (ICS) are the cornerstone of asthma management and result in improved symptom control and quality of life for many patients. However, as for all medicines, the physician must achieve a balance between the potential benefits for the patient and the risk of side effects. For ICS therapy, the potential side effects may be […]
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