Inhaled corticosteroids moon face

Advair (Fluticasone + Salmeterol) :    The original combination inhaler is still the most popular.     Basically it combines a steroid with a long acting beta adrenergic (LABA).   The steroid  controls inflammation while the LABA keeps your lungs relaxed around the clock.   The combination of these medicines has worked wonders for many asthmatics.  The best part of this medicine is all you need to do is take one puff in the morning and one before bed.   This greatly improves complaince, and that alone I think has benefited many asthmatics.

Fluticasone propionate, a component of ADVAIR DISKUS, will often help control asthma symptoms with less suppression of HPA function than therapeutically equivalent oral doses of prednisone. Since fluticasone propionate is absorbed into the circulation and can be systemically active at higher doses, the beneficial effects of ADVAIR DISKUS in minimizing HPA dysfunction may be expected only when recommended dosages are not exceeded and individual patients are titrated to the lowest effective dose. A relationship between plasma levels of fluticasone propionate and inhibitory effects on stimulated cortisol production has been shown after 4 weeks of treatment with fluticasone propionate inhalation aerosol. Since individual sensitivity to effects on cortisol production exists, physicians should consider this information when prescribing ADVAIR DISKUS.

30 mg/kg/dose (Max: 1 gram/dose) IV or IM once daily for 1 to 3 days. High-dose pulse steroids may be considered as an alternative to a second infusion of IVIG or for retreatment of patients who have had recurrent or recrudescent fever after additional IVIG, but should not be used as routine primary therapy with IVIG in patients with Kawasaki disease. Corticosteroid treatment has been shown to shorten the duration of fever in patients with IVIG-refractory Kawasaki disease or patients at high risk for IVIG-refractory disease. A reduction in the frequency and severity of coronary artery lesions has also been reported with pulse dose methylprednisolone treatment.

Zab Mosenifar, MD, FACP, FCCP  Geri and Richard Brawerman Chair in Pulmonary and Critical Care Medicine, Professor and Executive Vice Chairman, Department of Medicine, Medical Director, Women's Guild Lung Institute, Cedars Sinai Medical Center, University of California, Los Angeles, David Geffen School of Medicine

Zab Mosenifar, MD, FACP, FCCP is a member of the following medical societies: American College of Chest Physicians , American College of Physicians , American Federation for Medical Research , American Thoracic Society

Disclosure: Nothing to disclose.

"Rick’s growth and bone development have been affected by his high steroid use.   He was evaluated completely in the Pediatric Endocrinology clinic at the children’s hospital.   Their findings indicate Rick is constitutionally delayed in growth and his severe asthma and requirements for high-dose steroids over the past several years have contributed to this delay.   Based on their information, Rick has an estimated adult height of 5 feet 6 inches. Rick also has steroid induced osteoporosis that needs to be dealt with.  "

Inhaled corticosteroids moon face

inhaled corticosteroids moon face

Zab Mosenifar, MD, FACP, FCCP  Geri and Richard Brawerman Chair in Pulmonary and Critical Care Medicine, Professor and Executive Vice Chairman, Department of Medicine, Medical Director, Women's Guild Lung Institute, Cedars Sinai Medical Center, University of California, Los Angeles, David Geffen School of Medicine

Zab Mosenifar, MD, FACP, FCCP is a member of the following medical societies: American College of Chest Physicians , American College of Physicians , American Federation for Medical Research , American Thoracic Society

Disclosure: Nothing to disclose.

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