Common concerns about asthma medicines

ankur patel

Common concerns about asthma medicines

Laboratory studies suggest inhaled corticosteroids reduce the number of these receptors in the airways and so may block entry of the virus into human cells. Every time you go for an asthma review ask your GP or asthma nurse to check your inhaler technique. Watch our inhaler videos, and ask your GP or asthma nurse to check your inhaler technique when you go for your asthma review. You can also ask your local pharmacist to check your inhaler technique.

  • Patients under 50 years old with severe asthma, and all those over 50 years with another chronic lung condition, had an increased risk of death.
  • Patients who smoke  may require higher doses of ICS compared with non-smokers for the same therapeutic effect.
  • All patients taking ICS who have never had chickenpox should be advised to avoid people with chickenpox or shingles, and to see a doctor if they come in contact with someone with either illness and then feel unwell.
  • UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments.
  • Steroid tablets that are taken for a short period of time are unlikely to cause side effects.

Women using an inhaled corticosteroid in pregnancy will not usually need any extra monitoring. All patients using ICS should be advised to rinse out their mouth with water (spitting out the rinse) and brush their teeth after using their device, which will reduce the risk of developing a sore where do you buy steroids throat or hoarseness. Spacer devices can also be used to reduce oropharyngeal deposition of drug particles, and should be recommended for all ICS multi-dose inhalers[12] . Inhaled corticosteroids are commonly prescribed but need careful management to minimise the risk of side effects.

Budesonide will form part of the UK’s priority platform trial for Covid-19 treatments that can be taken at home.

They will be followed-up for 28 days and will be compared with participants who have been assigned to receive the usual standard-of-care only. They will be asked to inhale two puffs twice a day for 14 days with each puff providing a 400 microgram dose of budesonide. Cough has been found to be the major problematic symptom of asthma followed by wheeze, runny nose and worsening symptoms after physical activity in participants of both the groups (Figure 2).

  • If a patient is stable i.e. good asthma control with no exacerbations for 3 months, the dose of ICS can be reduced by 25-50%.
  • The trial was inspired by the fact that, in the early days of the pandemic, patients with chronic respiratory disease, who are often prescribed inhaled steroids, were significantly under-represented among those admitted to hospital with COVID-19.
  • Taking high doses for a long time can slow down the normal growth of children and teenagers.
  • You can get help with your inhaler technique, or see if there is another inhaler type that would suit you better.
  • This covers more than 15.4 million patients from 738 doctors’ surgeries across the UK–equivalent to 7% of the UK population.
  • So these are listed as common side effects in the patient information leaflet.

They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account. Before increasing dose of ICS, a patient’s adherence to treatment, inhaler technique and inhaler device (MDI + spacer) should be considered. The reason for this difference in efficacy may be related to the mechanism of action of ICS. In asthma, inflammation is primarily caused by eosinophils, while in stable COPD neutrophils are predominant[8] .

Inhaled Corticosteroids

If this isn’t possible, there may be different asthma medicines you can try. Dry powder inhalers have a lower impact on the environment than breath-actuated or pressurised metered dose inhalers. Propellants used in inhalers contain greenhouse gases and can add to global warming. When you first start using a preventer inhaler, it takes a few days for the medicine to start working.

In all patients, nocturnal symptoms occurred in the last week with a mean of 3.35 ± 2.59 days, while physical activity was restricted for 0.68 ± 1.55 days and duration of attacks were found to be 4.82 ± 3.60 times per year. Asthma is a common chronic obstructive pulmonary disorder that usually becomes the major reason of disability, economic burden and poor quality of life [1]. The global burden of Asthma has been reported as 4.3%, where the highest burden was observed in Western Pacific with 6.2%.

How do I know when there’s no medicine left in my inhaler?

Inhaled corticosteroids (ICSs) are indicated in the management of most patients with asthma and some patients with chronic obstructive pulmonary disease (COPD) [1],[2] . NHS data for 2013–2014 suggests that, in England, of the 242 million ICS-containing inhalers dispensed at a cost of almost £355m, 39% were for high-dose inhalers. Around 4.3 million adults in the UK are currently treated for asthma, costing the NHS around £1 billion each year.

It is therefore important that all smokers using an ICS should be offered help to stop smoking, as this may reduce the dose required by the patient and minimise the risk of side effects. Patients who are using high-dose ICS should be advised to inform the healthcare team responsible for their treatment if they fall ill for any reason, as this may affect the dose required. In addition, they should see a GP if they have symptoms that could be related to ICS treatment (e.g. worsening fatigue, muscle weakness, loss of appetite, unintentional weight loss, dizziness, unexplained nausea, vomiting and diarrhoea).

Inhaled corticosteroids (beclometasone, budesonide, ciclesonide, fluticasone, and mometasone) control inflammation in the lungs and are most commonly used to treat asthma. The BTS/SIGN guidelines recommend that the dose of any ICS should be reduced by 25–50% in patients with good asthma control (i.e. no exacerbations for three months), to the lowest dose that controls symptoms[2] . It is unlikely a patient with asthma would have their ICS completely withdrawn.

Inhaled Steroids in Asthma during the COVID-19 Outbreak

The very low, low, medium and high dose ICS categories have been taken from the British Thoracic Society (BTS) and the Scottish Intercollegiate Guidance Network (SIGN) British guideline on the management of asthma (2019). Doses are presented in comparison to standard BDP equivalency per day. The researchers investigated what symptoms patients had and how unwell they were when they arrived at hospital, followed by what level of treatment they required and their risk of death.

What do I do with my empty inhalers?

However, risks – albeit small – are still present and many patients or parents can be understandably anxious about ICS use. There aren’t usually any severe side effects if you take steroid injections, a steroid inhaler, or a short course of steroid tablets. However, prolonged treatment at high doses can cause problems in some people.