Respiratory Inhalant Corticosteroids
Written by Med-Scope
Respiratory Inhalant Corticosteroids
Generic and Trade Names:
Beclomethasone Dipropionate Beclovent, Vanceril Budesonide Pulmicort 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.
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