Respiratory Treatments

Anmerkungen:

• MOA: Reduce Air Inflammation by inhibiting infiltration of inflammatory cells and decrease oedema by an action on vascular endothelium.

1. Beclometasone
2. Budesonide
3. Fluticasone
4. Mometasone
5. Prednisolone

   Anmerkungen:

   • ORAL: Morning dose to mimic circadian rhythm, for 3 to 5 days.

1. Candidiasis

   Anmerkungen:

   • Use spacer, or rinse mouth (feed infants) after inhaler use. If facemask used, wipe face & apply emollient. Regular new toothbrush. 
2. Cataracts

   Anmerkungen:

   • Minimize by applying good seal around inhaler or mask, and use  'lowest effective dose' (LED)
3. Indigestion, Peptic Ulceration

   Anmerkungen:

   • Give tablets with breakfast or morning milk
4. Adrenal suppression

   Anmerkungen:

   • May occur >1.6mg beclometasone equivalent: Use LED.
5. Cushing Syndrome

   Anmerkungen:

   • Use LED
6. Osteoporosis

   Anmerkungen:

   • Provide calcium supplements

1. Increase Effects
   1. Ciclosporin

      Anmerkungen:

      • Increase Steroid Effect
2. Decrease Effect
   1. Anticonvulsants

      Anmerkungen:

      • Decrease steroid effects
   2. Antidiabetics

      Anmerkungen:

      • Hypoglycaemic Effect
   3. Antihypertensives

      Anmerkungen:

      • Hypotensive effect
   4. Diuretics

      Anmerkungen:

      • Decrease Diuretic Effect
   5. Vaccines

      Anmerkungen:

      • Decrease immune response
3. Anticoagulants
   1. May enhance or reduce

Anmerkungen:

• Leukotrienes D4 (LTD4), LTC4 and LTE4 are potent bronchoconstrictors that contribute to early phase bronchospasm and late phase inflammation

1. Montelukast
2. Zafirlukast

1. GI common
2. Headache
3. Hyperkinesia (in children)
4. Hypersensitivity Reactions