Inhalationssteroid vid kol

REK LISTAN 2013 7 ∏ UTBYTBART LÄKEMEDEL AKUT OBSTRUKTION VID ASTMA OCH KOL betametason Betapred ipratropium∏ lösning för nebulisator prednisolon Prednisolon salbutamol∏ lösning för nebulisator teofyllin Teovent, klysma terbutalin Bricanyl, inj theofyllamin Teofyllamin, inj ANDRAHANDSVAL Snabbverkande beta-2-stimulerare salbutamol Airomir/Autohaler Ventoline/Diskus/Evohaler terbutalin Bricanyl/Turbuhaler Långverkande beta-2-stimulerare formoterol Formatris Novolizer Oxis Turbuhaler indakaterol Onbrez Breezhaler salmeterol Serevent Diskus Fosfodiesterashämmare roflumilast Daxas Hosta Inga preparat är subventionerade, gäller både barn och vuxna. Se terapigruppens hemsida. Indikationen för Daxas är KOL vid stadium 3-4 med kronisk bronkit och upprepade exacerbationer. Endast subvention till patient som har provat inhalationssteroid och LABA och bedöms olämplig för inhalationssteroidbehandling. Halv dos initialt pga GI-biverkningar. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 . se /vardgivarstod/andning

Inhaled steroids have for several decades been a cornerstone of asthma treatment. They have a reputation of being well tolerated and having few side effects. It is common knowledge that long-time systemic steroid treatment is accompanied by a multitude of side-effects. One of them is the effect on the hypothalamic-pituitary-adrenal axis with more or less decreased function of the adrenal cortex. In the literature there are some case reports of adrenal insufficiency secondary to treatment with inhaled steroids, mostly among chil­dren. We report three cases of secondary adrenal insufficiency in adult asthmatics treated with fluticasone propionate with doses slightly above the recommended limit. Our conclusion is that significant adrenal side effects of inhaled steroids seem to be more common than previously thought. The recommendation is to measure cortisol in serum (in the morning) or make a Synacthen test in patients that could be at risk of adrenal dysfunction.

Inhalationssteroid vid kol

inhalationssteroid vid kol

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