Inhaled Steroids

Summary

Inhaled steroids include the drugs budesonide, fluticasone, and beclomethasone. They have anti-inflammatory effects that are useful in treating asthma. Inhaled steroids are long-acting drugs, meaning they act slowly and are best suited for maintenance treatment, and not for acute exacerbations. When prescribed together with a beta-2 agonist, the steroid should be taken after the beta-2 agonist. The biggest side effect of inhaled steroids is oral candidiasis, which can be prevented by rinsing out the mouth after each use.

Key Points

• Inhaled Steroids (Glucocorticoids)
  • Key Drugs
    • Fluticasone
    • Beclomethasone
    • Budesonide
    • Mometasone
    • Ciclesonide
  • Mechanism
    • Anti-inflammatory
      • When inhaled, steroids work to reduce bronchial inflammation
  • Clinical Use
    • Asthma
      • Long-term management; Used for maintenance therapy.
      • Cannot treat acute exacerbations; not a rescue medication
      • When a client is prescribed both a beta-2 agonist and an inhaled glucocorticoid, the beta-2 agonist should be administered first, followed by the steroid
        • The beta-2 agonist will open the bronchioles, allowing for better absorption of the glucocorticoid
  • Side Effects
    • Oral Candidiasis
      • Also called thrush, caused by candida albicans
      • A white furry coating inside the mouth
      • Can be prevented by using a spacer and rinsing mouth after inhalation
    • Local irritation
      • Hoarseness
      • Dry mouth
      • Coughing