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Respiratory Inhalant Corticosteroids

Respiratory Inhalant Corticosteroids

Generic and Trade Names:

Beclomethasone DipropionateBeclovent, Vanceril
BudesonidePulmicort
Dexamethasone sodium phosphate Decadron Phospha
Respihaler
Flunisolide AeroBid, Aerobid-M
Fluticasone Propionate Flovent
Triamcinolone Acetonide Azmacort



Description:

These medications are adrenocortical steroids that are used in the management of asthma and related symptoms. The exact mechanism of action of these drugs is unknown. They may cause a number of different actions, for example reducing the activity of inflammatory cells, or relax smooth muscles, as well as decreasing airway hyperresponsiveness. In general these drugs have less systemic side effects associated with them. (Facts and Comparisons 1999)

Nutritional Considerations:

Avoid alcohol. (Pronsky 1999)

Monitor glucose levels, especially in diabetics. (Pronsky 1999)

Vitamins A,C,D and calcium may need to be supplemented with long term use. (Adler 1994)(Pronsky 1999)

Oral fungal infections are possible, rinse mouth out with water after each use of the inhaler, do not swallow the water. (Facts and Comparisons 1999)

Herbal Considerations

Licorice may interact with these agents to potentiate their effects. (Brinker 1998)

The German Commission E notes the increased effectiveness and side effects of simultaneously administered Lily of the Valley or squill and: calcium, quinidine, saluretics (increase the elimination of salts in the urine), laxatives and extended therapy with glucocorticoids (i.e. corticosteroid drugs)

Ephedrine can increase the clearance of dexamethasone and reduce it's effects. (Brinker 1998)

References:

Adler RA & Rosen CJ: Corticosteroids and Osteoporosis. Endocrinol Metab Clin North Am 1994; 23:655670.

Brinker, Francis N.D. Herb Contraindications and Drug Interactions. Eclectic Medical Publications, 1998.

Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 1999.

Kennedy MC, Posner E & Thursby-Pelham DC: Long-term treatment of asthma with beclomethasone dipropionate. Postgrad Med J 1975; 51(Suppl 4):84-86.

Mantero F & Boscaro M: Glucocorticoid-dependent hypertension. J Steroid Biochem Mol Biol 1992; 43:409-413.

Milne L & Crompton GK: Beclomethasone dipropionate and oropharyngeal candidiasis. Br Med J 1974; 3:797-798.

Olefsky JM & Kimmerling G: Effects of glucocorticoids on carbohydrate metabolism. Am J Med Sci 1976; 271:202-210.

Pandit MK, Burke J, Gustafson AB et al: Drug-induced disorders of glucose tolerance. Ann Intern Med 1993; 118:529-539.

Pronsky, Zaneta. Food Medication Interactions. 11th edition. 1999.