SIDE-EFFECTS OF INHALED CORTICOSTEROIDS

Inhaled corticosteroid (ICS) therapy carries less risk of complicating drug- or disease-related morbidity and mortality than that associated with other antiasthmatic drugs such as prednisone, theophylline, or b eta(2)-agonist bronchodilators. Serious side effects are uncommon, but the risk increases with the daily dose. The degree of risk is most ef fectively minimized by ensuring each patient uses the smallest daily d ose sufficient to maintain optimum control of their disease. Any patie nt in whom ocular symptoms develop while receiving ICS therapy should promptly be evaluated by an eye specialist. Growth, velocity is common ly reduced during ICS therapy and should he monitored routinely. Bone metabolism may be affected by ion or medium doses of ICS, but there is no evidence such doses cause osteoporosis or fracture, High-dose ther apy may. reduce hone density and increase the risk of fracture, partic ularly if other risk factors for osteoporosis are present. Research is needed to better define the impact of ICS therapy in children on heig ht and peak hone density. attained at maturity, Also, there is a need for practice guidelines specifically applicable to the prevention of b one loss during ICS treatment.