Respiratory Treatments

Anotações:

• 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

   Anotações:

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

1. Candidiasis

   Anotações:

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

   Anotações:

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

   Anotações:

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

   Anotações:

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

   Anotações:

   • Use LED
6. Osteoporosis

   Anotações:

   • Provide calcium supplements

1. Increase Effects
   1. Ciclosporin

      Anotações:

      • Increase Steroid Effect
2. Decrease Effect
   1. Anticonvulsants

      Anotações:

      • Decrease steroid effects
   2. Antidiabetics

      Anotações:

      • Hypoglycaemic Effect
   3. Antihypertensives

      Anotações:

      • Hypotensive effect
   4. Diuretics

      Anotações:

      • Decrease Diuretic Effect
   5. Vaccines

      Anotações:

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

Anotações:

• 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