Corticosteroid therapy inhaled preparations

Corticosteroid therapy, oral or parenteral (by inhalation) may offer dramatic relief from asthma when other less dangerous measures have failed. At least one of the inhalant preparations (beclomethasone dipropionate) seems to compete favourably with other anti-asthmatics as far as the risks involved are concerned. Recent data on the corticosteroids in all their forms can be found in Chapter 37. 

Self-limited disease Amphotericin 6 0.3-0.5 mg/kg/day x 2-4 weeks (total dose 500 or ketoconazole 400 mg orally daily x 3-6 months can be beneficial in patients with severe hypoxia following inhalation of large inocula Antifungal therapy generally not useful for arthritis or pericarditis NSAIDs or corticosteroids can be useful in some cases Most lesions resolve spontaneously surgery or antifungal therapy with amphotericin B 40-50 mg/dayx2-3 weeks or itraconazole 400 m day orally x 6-12 months can be beneficial in some severe cases mild to moderate disease can be treated wHh itraconazole for 6-12 months Amphotericin B 0.7 mg/k day, for a total dose of SSm kg (or 3 rng/k day of one of the lipid preparations) prednisone 60 mg daily tapered over 2 weeks/ followed by itraconazole 200 rng twice daily for 6-12 weeks in patients who do not require hospitalization, itraconazole 200 mg once or twice daily for 6-12 weeks can be used... 

CB s asthma is currently being treated with a low-dose of the inhaled corticosteroid beclomethasone dipropionate (QVAR, 40 pg b.i.d.). She is in your pharmacy now with prescriptions for both chronic medications written by her new provider. After taking her medical history and reviewing her psychosocial situation, you recognize that she has many risk factors for near-fatal asthma" and believe she should have ready access to rescue therapy in case she experiences an acute episode of severe bronchoconstriction. Consider the structures of the adrenergic agents drawn below, and prepare to make a therapeutic recommendation to CB s new physician. 

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