Adrenal suppression
Posted: 30th July 2013 | Posted by AdminMR
Adrenal suppression: A practical guide to the screening and management of this under-recognized complication of inhaled corticosteroid therapy
Allergy, Asthma & Clinical Immunology
…effective anti-inflammatory therapy is essential for the treatment of asthma, that ICSs are the most effective anti-inflammatory agents available, and that the suppressive effects of ICS therapy on the HPA axis is markedly less than clinically equivalent doses of oral corticosteroids. At low-to-moderate doses, ICS therapy does not present any significant risk for systemic side effects. However, when high doses are used for prolonged periods, serious adverse events, including AS, are possible. The risk for AS can be minimized through increased awareness and early recognition of at-risk patients, regular patient follow-up to ensure the lowest effective ICS doses are utilized, and by choosing an ICS medication with minimal systemic effects. When high-dose ICS therapy is required, important differences in the PK and PD characteristics of the available ICSs warrant consideration in clinical practice. For patients with proven AS, family education and stress steroids during times of illness, injury or surgery are imperative and will help reduce the morbidity associated with this serious complication of ICS therapy….