Does prednisone help with bronchitis symptoms? A new study suggests that steroid pills do not provide clinically useful benefits for patients with acute lower respiratory tract infections.

Steroid Pills Fail to Improve Bronchitis Symptoms

A recent British study published in the Journal of the American Medical Association found that prescribing oral steroids, such as prednisone, does not provide meaningful benefits for patients with acute bronchitis or other short-term lower respiratory tract infections.

The study, led by Dr. Alastair Hay from the University of Bristol, involved nearly 400 adult participants who did not have asthma. Half of the patients received 40 milligram pills containing an oral steroid for five days, while the other half received an identical inactive placebo for the same duration.

The researchers found that the patients who took the steroid pills did not experience any reductions in symptom duration or severity compared to those who received the placebo. “Our study does not support the continued use of steroids as they do not have a clinically useful effect on symptom duration or severity,” said Dr. Hay. “We would not recommend their use for this group of patients.”

The Ineffectiveness of Steroids for Bronchitis

Bronchitis is a common respiratory condition characterized by inflammation and irritation of the bronchial tubes, the airways that carry air to and from the lungs. Acute bronchitis is often caused by viral infections and can result in symptoms such as cough, mucus production, and difficulty breathing.

While doctors sometimes prescribe oral steroids like prednisone to help manage bronchitis symptoms, the new study suggests this approach is not warranted. The findings indicate that steroid medications do not provide clinically meaningful benefits for patients with acute lower respiratory tract infections, including bronchitis.

Asthma vs. Bronchitis: Different Treatments

It’s important to note that the study excluded participants with asthma, as steroids can be an effective treatment for managing asthma symptoms. Prednisone and other systemic steroids are often used to treat asthma attacks or to help control long-term, difficult-to-manage asthma.

Unlike bronchitis, asthma is a chronic condition characterized by inflammation and narrowing of the airways. Inhaled corticosteroids are commonly used as a first-line controller treatment for asthma, helping to reduce airway inflammation and prevent symptoms.

Alternatives to Steroid Treatments for Bronchitis

If steroid medications are not recommended for treating bronchitis, what other options are available? The study authors suggest that healthcare providers should focus on supportive care measures, such as:

• Encouraging rest and hydration
• Recommending over-the-counter cough suppressants or expectorants
• Advising on effective home remedies like honey, ginger, or steam inhalation

For some patients with persistent or severe bronchitis symptoms, antibiotics may be prescribed if a bacterial infection is suspected. However, the researchers note that most cases of acute bronchitis are caused by viral infections, which do not respond to antibiotic treatment.

Implications for Clinical Practice

The findings from this study have important implications for healthcare providers who treat patients with acute bronchitis or other lower respiratory tract infections. The study’s lead author, Dr. Hay, stated that the results “do not support the continued use of steroids” for this patient population, as they do not provide meaningful clinical benefits.

By avoiding unnecessary steroid prescriptions, healthcare providers can help mitigate the potential side effects associated with these medications, such as weight gain, elevated blood sugar, and bone thinning. The study emphasizes the importance of evidence-based decision-making and tailoring treatments to the specific needs and characteristics of each patient.

Conclusion

In conclusion, this new study challenges the common practice of prescribing oral steroids, such as prednisone, for the treatment of acute bronchitis and other lower respiratory tract infections. The findings suggest that steroid medications do not provide clinically useful improvements in symptom duration or severity for these patients. Healthcare providers should instead focus on supportive care measures and avoid unnecessary steroid prescriptions, which can help prevent potential side effects and promote more effective management of bronchitis and similar respiratory conditions.

Prednisone for Asthma Treatment: Benefits and Side Effects

Steroids, anti-inflammatory drugs such as prednisone, can be used for asthma as well as other lung diseases. Prednisone and other steroids (inhaled, oral, or by injection) help calm airway inflammation in asthma. If you’ve ever had a serious asthma attack, you may have had high doses of steroids administered intravenously in the hospital.

What Is Prednisone?

Prednisone is an oral steroid medication. If you have serious worsening of asthma symptoms (an asthma attack), your doctor may prescribe a brief course of oral steroids such as prednisone. Oral steroids may also be prescribed when your asthma symptoms worsen but you do not require hospitalization.

How Does Prednisone Treat Asthma?

Oral prednisone is a systemic anti-inflammatory steroid. That means that after taking prednisone by mouth (orally), it is absorbed in the body, unlike inhaled steroids (anti-inflammatory asthma inhalers) that go straight to the lungs. Prednisone decreases your immune system’s response to reduce symptoms such as swelling and allergic-type reactions.

Prednisone and other systemic steroids may be used to treat asthma attacks and help people gain better asthma control. Steroids are used with other asthma medications to either control sudden and severe asthma attacks or to treat long-term, hard-to-control asthma.

How Long Does It Take for Prednisone to Treat Asthma?

Sometimes systemic steroids like prednisone are taken in high doses for a few days. This is called a steroid burst. They may also be given in a low dose daily or every other day for long-term asthma control.

Is Prednisone the Only Systemic Steroid for Asthma?

Besides prednisone, other systemic steroids used in the treatment of asthma include:

Are Prednisone and Other Oral Steroids Safe for Asthma?

While a two-week course or “short burst” of oral steroids like prednisone is relatively safe, it’s important to avoid steroids on a long-term basis as there are potential serious side effects. Taking supplemental calcium may help to prevent osteoporosis or thinning of the bones, which is one of the side effects of long-term steroid use.

What if I Need to Take Steroids Frequently for Asthma?

If you need steroids frequently for “rescue” therapy, this can suggest poor control of airway inflammation or continued exposure to some unsuspected allergen. In this case, talk to your health care provider about inhaled anti-inflammatory medications.

What Are the Side Effects of Prednisone and Other Steroids?

Steroids have many potential side effects, especially when given orally and for a long period of time. Side effects with short-term steroid use include:

• Weight gain
• Fluid retention
• High blood pressure
• Elevated blood sugar

Side effects with long-term steroid use include:

• Growth suppression
• Diabetes
• Cataracts of the eyes
• Bone-thinning osteoporosis
• Muscle weakness

When Are Inhaled Steroids Used for Asthma?

Anti-inflammatory asthma inhalers are often used as a first-line controller treatment for asthma. After introduction of inhaled steroids, the need for oral steroids such as prednisone may decrease.

Unlike the serious side effects of oral steroids, the most common side effects of anti-inflammatory asthma inhalers are hoarseness and thrush, especially in elderly adults. As with all asthma inhalers, you should rinse the mouth carefully after using your inhaler. Gargle with water after inhalation to help reduce the risk of oral thrush.

For more detail, see WebMD’s Asthma, Steroids & Other Anti-Inflammatory Drugs.

Steroid Pills Often Fail Against Bronchitis

By Mary Elizabeth Dallas

HealthDay Reporter

WEDNESDAY, Aug. 23, 2017 (HealthDay News) — Doctors sometimes prescribe a steroid for patients with bronchitis or other troublesome chest infections, but a new British study says the approach isn’t warranted.

“Our study does not support the continued use of steroids as they do not have a clinically useful effect on symptom duration or severity,” said study lead researcher Dr. Alastair Hay, who teaches primary care medicine at the University of Bristol.

“We would not recommend their use for this group of patients,” Hay said in a university news release.

For the study, Hay’s team tracked outcomes for nearly 400 adults with acute (short-term) lower respiratory tract infections. The participants, who did not have asthma, were split into two groups. Half of the patients received 40 milligram pills containing an oral steroid for five days, while the other half received an identical inactive placebo for the same length of time.

None of the patients had pneumonia or bacterial infections that required antibiotics, the researchers noted.

The study, published Aug. 22 in the Journal of the American Medical Association, found the patients on steroids had no reductions in severity or duration of their cough or other symptoms, compared to those who took the placebo. That suggests that the steroids weren’t effective in treating the chest infections, Hay’s team said.

As Hay explained, many chest infections are viral, and patients are often inappropriately given an antibiotic — which can only fight off bacterial infections — in an attempt to treat them. When that approach fails, physicians often turn to steroids.

Steroid medications “are increasingly being used to try to reduce the symptoms of chest infections, but without sufficient evidence,” Hay said. The new study suggests steroids won’t help either, and they come with certain hazards.

According to study co-author Mike Moore, from the University of Southampton, the drugs “need to be used carefully because of the risk of unwanted side effects.”

Steroid medications can successfully help ease asthma flare-ups, Moore noted in the news release, and “we chose to test the effect of steroids for chest infections as some of the symptoms of chest infections — such as shortness of breath, wheeze and cough with phlegm — overlap with acute asthma.”

Two U.S. experts in respiratory health said the new study gives patients and doctors valuable information.

Dr. Howard Selinger is head of family medicine at the Netter School of Medicine at Quinnipiac University in Hamden, Conn. He said that “it is heartening to know that clinicians can reassure patients that if they have a viral process, and if they are otherwise healthy and have no pneumonia,” the correct course of treatment is not steroids, but hydration and medicines aimed at easing cough and congestion.

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, agreed. But he added that the advice might be different in people with asthma.

“In adults with asthma, any infection may cause a flare of asthma, and steroids might be indicated in this population of patients, depending on the severity of the asthma symptoms,” Horovitz said.

Skip the steroids for bronchitis : Evidence-Based Practice

What’s your profession?Academic MedicineAcute Care NursingAddiction MedicineAdministrationAdvanced Practice NursingAllergy & ImmunologyAllied HealthAlternative & Complementary MedicineAnesthesiologyAnesthesiology NursingAudiology & Ear and HearingBasic ScienceCardiologyCardiothoracic SurgeryCardiovascular NursingCardiovascular SurgeryChild NeurologyChild PsychiatryChiropracticsClinical SciencesColorectal SurgeryCommunity HealthCritical CareCritical Care NursingDentistryDermatologyEmergency MedicineEmergency NursingEndocrinologyEndoncrinologyForensic MedicineGastroenterologyGeneral SurgeryGeneticsGeriatricsGynecologic OncologyHand SurgeryHead & Neck SurgeryHematology/OncologyHospice & Palliative CareHospital MedicineInfectious DiseaseInfusion NursingInternal/General MedicineInternal/General Medicine ResidencyLibrary SciencesMaternal Child NursingMedical OncologyMedical ResearchNeonatal/PerinatalNeonatal/Perinatal NursingNephrologyNeurologyNeurosurgeryNursing-administrativeNursing-all SpecialtiesNursing-educationNutrition & DieteticsObstetrics & GynecologyObstetrics & Gynecology NursingOccupational & Environmental MedicineOncology NursingOncology SurgeryOphthalmology/OptometryOral & Maxillofacial SurgeryOrthopedic NursingOrthopedics/Spine/Sports Medicine SurgeryOtolaryngologyPain MedicinePathologyPediatric SurgeryPediatricsPharmacologyPharmacyPhysical Medicine & RehabilitationPhysical Therapy & Womens Health Physical TherapyPlastic SurgeryPodiatary-generalPodiatry-generalPrimary Care/Family Medicine/General PracticePsychiatric NursingPsychiatryPsychologyPublic HealthPulmonologyRadiation Oncology/TherapyRadiologyRheumatologySkills & ProceduresSleep MedicineSport & Exercise/Training/FitnessSports MedicineSurgical NursingTransitional CareTransplant SurgeryTrauma NursingTrauma SurgeryUrologyWomens HealthWound CareOther

What’s your speciality?Addiction MedicineAllergy & Clinical ImmunologyAnesthesiologyAudiology & Speech-Language PathologyCardiologyCardiothoracic SurgeryCritical Care MedicineDentistry, Oral Surgery & MedicineDermatologyDermatologic SurgeryEmergency MedicineEndocrinology & MetabolismFamily or General PracticeGastroenterology & HepatologyGenetic MedicineGeriatrics & GerontologyHematologyHospitalistImmunologyInfectious DiseasesInternal MedicineLegal/Forensic MedicineNephrologyNeurologyNeurosurgeryNursingNutrition & DieteticsObstetrics & GynecologyOncologyOphthalmologyOrthopedicsOtorhinolaryngologyPain ManagementPathologyPediatricsPlastic/ Reconstructive SugeryPharmacology & PharmacyPhysiologyPsychiatryPsychologyPublic, Environmental & Occupational HealthRadiology, Nuclear Medicine & Medical ImagingPhysical Medicine and RehabilitationRespiratory/Pulmonary MedicineRheumatologySport Medicine/ScienceSurgery (General)Trauma SurgeryToxicologyTransplantation SurgeryUrologyVascular SurgeryVirologyI don’t have a medical specialty

What’s your work setting?Hospital Under 250 BedsHospital Over 250 BedsEldercare or Hospice FacilityPsychiatric or Rehabilitative FacilityPrivate PracticeGroup PracticeCorporation (Pharmaceutical, Biotechnology, Engineering, etc. )Doctoral University or Medical SchoolMasters or 4-Year Academic UniversityCommunity CollegeGovernmentOther

Analgesic and antipyretic agents, Corticosteroids, systemic, Bronchodilators, Antibiotics, Antivirals, Corticosteroids, inhaled, Anti-inflammatory Agent

National Emphysema Foundation – Is Prednisone a Friend or Foe?

Probably just about everyone who reads this monthly Newsletter knows about prednisone.  Prednisone is in a class of drugs called corticosteroids, related to the cortisone group of medications.  These drugs are highly useful in the management of asthma and some patients with COPD, and, quite frankly, I couldn’t get along without them in my practice.  This statement has to be tempered with the clear understanding of what I call the “downside” of these valuable drugs, and these can be substantial.  Yet many of the side effects can be avoided or minimized with certain strategies.

Prednisone is an anti-inflammatory drug and thus deals with inflammation of the conducting air passages in the lung.  Inflammation may be present in both asthma and COPD.  The strategic use of prednisone can soothe and thus heal the delicate lining layer of these passageways, making them more resistant to bronchospasm.  Prednisone has another effect in preserving or even increasing the receptors for inhaled bronchodilators.  Thus prednisone is used both to combat inflammation and to enhance the effectiveness of one of the most valuable bronchodilators we have for asthma and COPD.  The downside is well-known.  It causes wear and tear on the bones, and in some patients the acceleration of cataract formation and the worsening of glaucoma (high pressure in the eyes).  The bone problem is much worse in women than men, and it is a particular problem in small-boned, light-skinned women beyond the menopause.  On the other hand, large-boned, dark-skinned people have relatively little trouble with prednisone. Men have far less trouble than women, probably because their bones are larger to start with.  The bone problem (osteoporosis) can be largely prevented by the appropriate use of calcium.  A quart of skim milk gives 1,000 mg of calcium, and simple medications such as Tums contain a lot of calcium.  Physicians believe that between 1,000-1,500 mg per day is necessary to help prevent osteoporosis.  Exercise also helps protect the bones, and, of course, being able to breathe makes this exercise possible.  (Newer medications have become available to help treat osteoporosis).

Anybody receiving long-term prednisone should have an annual eye exam and, of course, plenty of people have cataracts and glaucoma without the use of steroids.  If steroids are making things worse, that fact can be dealt with by using medications and surgery.  Short courses of prednisone cause almost no harm, and even low maintenance doses given each morning or evening in a single daily dose have minimal side effects in most patients.  Most of the other rumors about prednisone are blown way out of proportion, but it is true that some folks have more trouble from prednisone than others.  It’s hard to discuss all of the ins and outs of prednisone therapy in one short Newsletter, but the “bottom line” is prednisone is very useful in many patients and usually does a lot more good than harm.  I’ll be in touch with you next month with more information on prednisone and some additional tips which may be interest.

(NOTE:  Prednisone can also have an effect on blood sugar levels, which may be of importance to diabetics).

Dr. Thomas Petty, Professor of Medicine University of Colorado Health Sciences Center; Consultant and Faculty at HealthONE Center Denver, CO.

The Risks of Using Steroids for Respiratory Infections

In an interview, Dr. Dvorin said that although steroids may make people euphoric, they can also “make some people feel pretty bad by causing anxiety, jitteriness and manic-like behavior.” In people with pre-existing psychosis, short-term steroid shots can trigger a psychotic episode, Dr. McCoul said.

Drs. Dvorin and Ebell wrote, “Physicians might assume that short-term steroids are harmless and free from the widely known long-term effects of steroids. However, even short courses of systemic corticosteroids are associated with many possible adverse effects.” (“Systemic” refers to both oral and injected steroids, as opposed to topical uses on the skin.)

Furthermore, there is no credible evidence to justify such risks when treating a condition like a cold or sinus infection, the Michigan doctors noted. When any treatment is prescribed, it’s the practitioner’s job to first weigh its expected benefits against possible risks. However, Drs. Wallace and Waljee reported that “corticosteroid bursts are frequently prescribed for self-limited conditions, where evidence of benefit is lacking.” Leading the list of such inappropriate uses of steroids are acute respiratory tract infections that usually resolve without specific treatment within a week or two.

As with antibiotics and opiates, short-term use of injected or oral steroids have “well-defined indications but can cause net harm when used — as they frequently are — when evidence of benefit is low,” they concluded.

In Louisiana, where Dr. McCoul practices, steroid shots for upper respiratory infections are shockingly common, he said. “Patients may go to urgent care five or six times a year to get a steroid shot.” Although the drugs themselves are not addictive, getting these shots “is like a behavioral addiction,” he said.

“It’s a pervasive practice for which there’s practically zero evidence of benefit,” Dr. McCoul added. “It’s important for the public to understand that most upper respiratory infections are self-limited; no intervention is required. They resolve on their own if you don’t seek care.”

However, when patients do go to the doctor, they expect something to happen, and doctors are often happy to oblige. They are reimbursed by insurance if they administer an injection but not if they hand patients a prescription for oral steroids.

Canine Chronic Bronchitis | BluePearl Pet Hospital

Chronic Bronchitis: Symptoms, Diagnosis and Treatment

Chronic bronchitis is a disease in dogs that affects the smaller airways that branch out from the trachea (windpipe).

These branches, called bronchi and bronchioles, allow the transport of air into and out of the alveoli, the sites of oxygen exchange.

Typically, inflammation within the airways results in excessive secretions that plug the airways. The end result is an impaired ability to bring oxygen into the alveoli for delivery to the rest of the body.

Although the term “asthma” is occasionally used to describe this form of airway disease in dogs, this term is very misleading. Asthma in humans specifically refers to the reversible constriction of muscle within the walls of the bronchi. Chronic bronchitis (long duration, usually more than two to three months) is associated with inflammation and swelling of the walls of the bronchi resulting in narrowing of the airways and obstruction or blockage of airways by plugs of mucus or other secretions. The inflammation present in chronic bronchitis is not reversible.

As mentioned, bronchitis can be chronic or acute (short duration). Unlike chronic bronchitis, acute bronchitis is associated with reversible changes in the structure of the airways. Bronchitis may be caused by bacterial infections, hypersensitivity disorders (allergies), parasites (i.e., lung worms, heartworm) or chronic inhalation of airway irritants (second-hand smoke, dusts, exhaust fumes, etc.). In chronic bronchitis the underlying cause cannot be identified.

Symptoms

The most common signs of chronic bronchitis include daily coughing, difficulty breathing or wheezing for two to three months or longer. Coughing is often more pronounced initially upon awakening and then reduces in frequency while awake and active. Episodes of coughing can mimic vomiting; you may think that your dog is vomiting when in fact your dog is having a coughing fit followed by retching.

Some severely affected dogs may have extreme exercise intolerance. These signs are not specific for bronchitis and can also be seen with many other diseases including heart failure, pneumonia, allergic lung disease and lung cancer.

Diagnosis

To diagnose canine bronchitis, usually the first test is a chest radiograph (X-ray). The presence of radiographic changes to the airways combined with a clinical history of a middle- to older-aged dog with a cough for at least two to three months may be sufficient to establish a tentative clinical diagnosis of chronic bronchitis. However, bronchoalveolar lavage (BAL) may be recommended to exclude other airway diseases (lung parasites, allergic bronchitis).

This procedure allows collection of fluid and cells from your dog’s lungs. These samples are sent to a laboratory to determine what types of cellular changes are occurring in the lungs. If bacterial or parasitic infection is present, the results will help assist in determining what therapy might be most effective.

Bronchoalveolar lavage does require anesthesia, so if the patient’s condition is critical, it may not be possible to do this procedure because of increased risk of death. 

Treatment

Any underlying disease (i.e., bacterial or parasitic infection) must be diagnosed and treated. Changes may be needed in the dog’s environment. Dogs with chronic bronchitis often have sensitive airways, and the inhalation of irritating particles from certain environments may worsen their condition. It is strongly recommended that their exposure to smoke (cigarette or fireplace), dusts (carpet fresheners, flea powder), and sprays (insecticides, hair spray, perfumes and cleaning products) be eliminated or minimized.

Two classes of medications are commonly prescribed: bronchodilators (theophylline, aminophylline, pentoxifylline, and terbutaline) and corticosteroids (prednisolone, prednisone, and methylprednisolone).

Bronchodilators (in theory) help to dilate or open the airways by relaxing the muscles around the airway walls. The overall effectiveness of these drugs alone is minimal in most dogs. Common side effects of bronchodilators in dogs can include vomiting, nausea, restlessness and lethargy. Pentoxifylline is unique in that it has anti-inflammatory effects and may be effective in some dogs with mild disease.

Corticosteroids are anti-inflammatory drugs that decrease the inflammation and swelling of the airway walls. These medications are most effective for treatment of chronic bronchitis. Side effects of corticosteroids may include increased appetite, increased urination, increased thirst and anxiety (pacing, restlessness). Corticosteroid inhaler therapy is marginally effective, as our patients are not always cooperative, and delivery of the drug deep into the lungs is rarely achieved. 

Prognosis

Prognosis is variable with this disease. In most dogs, permanent damage to the airways has occurred and the disease cannot be cured. With proper medical management, clinical signs can usually be controlled and further damage to the bronchi can be stopped or slowed.

Periodic relapses of coughing are not unusual and require treatment. The cough is often not entirely eliminated, but reduced in patients with chronic bronchitis.

Some dogs with chronic bronchitis develop severe irreversible changes to the airways termed bronchiectasis. These dogs are highly susceptible to recurrent pneumonia. A sudden increase in cough in patients with bronchiectasis requires prompt evaluation and chest radiographs to determine whether pneumonia is present.

For more information on this subject, talk to the veterinarian treating your pet.

Glucocorticoids – Nikavet Veterinary Clinic

Author: Yakimenko Anastasia Sergeevna (translated from English)

Glucocorticoids (GC) have far-reaching pharmacological effects that can vary significantly depending on the dosage and slightly depending on the type of GC prescribed (see Pharmacological Effects of Glucocorticoids).

Pharmacological effects of glucocorticoids:

• Reduces the production of inflammatory mediators

• Attenuation of leukocyte phagocytosis, chemotaxis and antigen production

• Pronounced catabolic effect on metabolism, muscle mass and bone turnover

• Change in renal excretion of potassium, calcium and sodium

• Excitation of stress leukogram

• Serum induction of alkaline phosphatase

Prednisone, Prednisolone and Methylprednisolone

Prednisone is a prodrug of Prednisolone.In cats, oral prednisolone results in much higher plasma concentrations than the same oral prednisolone dose. This may be due to the poor bioavailability of prednisone in cats or its slow conversion to prednisone. For this reason, prednisone is the preferred HA for cats. Whereas dogs can convert both prednisone and prednisolone equally. Methylprednisolone is more effective than prednisolone in inhibiting lymphocyte proliferation in vitro in humans.But this data is not valid for dogs. Animal textbooks report that methylprednisolone has no mineralocorticoid effects compared to prednisolone, but there is no evidence for this. In fact, methylprednisolone activates the mineralocorticoids responsible for the renal tract, at least in rodents.

Dosage of Prednisol, Prednisolone and Methylprednisolone

The commonly used doses of HA have been extrapolated from previous human studies and supported by clinical experience in dogs and cats (Ref.empirical recommendations for glucocorticoid dosing). For physiological replacement, the recommended starting dose is 0.2 mg / kg orally once a day. The timing of manifestation is not important, at least in cats.

Doses exceeding the norm by about 3 times are recommended for stress (for example, hospitalization or surgery) in animals that have endogenous HA deficiency. This is supported by studies of the secretion of cortisol in dogs under experimental stress conditions.For anti-inflammatory effects, oral doses of 0.5 to 1.0 mg / kg per day for dogs and 1.0-2.0 mg / kg per day for cats are recommended; for immunosuppression, 2.0 mg / kg per day or 50 mg / m2 for dogs or up to 4.0 mg / kg per day for cats is suggested.

For large and giant dog breeds, use of no more than 50 mg / m2 (maximum dose 30-40 mg twice daily) is suggested by the author to reduce the incidence of serious side effects (eg muscle wasting, secondary infections). In obese cats, the dose of prednisolone should be administered based on an assessment of lean body mass, as the plasma concentration of prednisolone in obese cats is doubled compared to the same dosage per kg in normal cats.

Prednisolone is the preferred glucocorticoid for cats.

Positive and negative effects

Glucocorticoids commonly cause dose-dependent polyuria and polydipsia, muscle atrophy and alopecia in dogs. Cats are more resistant to many of the side effects of HA, possibly due to fewer and low affinity for HA receptors in the liver and skin. Acquired diabetes mellitus is a major complication of chronic HA treatment in cats and requires close clinical monitoring for polydipsia, weight loss, or glucosuria.Prednisone, prednisolone, and methylprednisolone have mineralocorticoid effects, and moderate to high doses should be avoided in patients with hypertension, heart failure, ascites, or hypokalemia. In addition, methylprednisolone acetate can cause acute plasma expansion and even congestive heart failure in cats, although this can be attributed to intercellular fluid changes rather than overall water retention. HAs typically induce serum alkaline phosphatase (ALP) activity in dogs, with alanine aminotransferase (ALT) inhibition.These changes are not clinically effective, unless the activity of ALT or ALP is exceeded, or hyperbilirubinemia is not present, which in itself suggests the presence of the disease.

ALP is not readily induced by HA in cats; slight increases in alkaline phosphatase from baseline were reported with methylprednisolone acetate, but values ​​were within the range. Any increase in serum ALP beyond the reference range is clinically significant in cats, regardless of whether HA is present in their treatment.

Two weeks of treatment with an anti-inflammatory dosage of prednisone suppresses the hypothalamic-pituitary-adrenal system (HPA system). After one month of treatment, it may take 2 weeks for adrenal function to recover. Because of this, the patient should ideally be isolated from chronic HA at least 2-3 weeks prior to elective anesthesia or surgery, if possible; however, if negative consequences of discontinuation of treatment are possible, then each patient should be considered separately.

Dexamethasone

Dexamethasone is approximately 5 to 10 times more potent than prednisone for a duration of approximately 32 to 48 hours. Dexamethasone does not have mineralocorticoid activity due to the substituted methyl ring and does not contribute to the retention of salt and water.

Indications and dosing

Dexamethasone is the preferred GC for patients with hypertension, heart failure, hypoalbuminemia, edema, or ascites.Based on the increased potency of dexamethasone, dosages can be empirically determined by calculating the base doses of prednisone and dividing by 7 or 8 to obtain the equivalent dexamethasone dose.

Dexamethasone is also available in injectable form, which is useful for the administration of HA bypassing severe malabsorption in the treatment of protein-losing enteropathy or lymphangiectasia.

Positive and negative effects

Dexamethasone (0.55 mg / kg orally per day) is more diabetogenic in healthy cats than eight times the dose of prednisolone (4.4 mg / kg orally per day).This suggests that dexamethasone is at least 8 times more potent than prednisone for cats.

Dexamethasone is not suitable for alternative single-use therapy due to its long duration of action. For chronic tapering courses, dexamethasone may be substituted for prednisone or prednisolone at lower doses (eg, equivalent to 0.5 to 1.0 mg / kg oral prednisolone per day) or with a single alternative therapy.

Budesonide

Budesonide is a high initial dosage oral HA for humans.In dogs, budesonide is unlikely to increase liver enzyme activity or cause a stress leukogram.

Indications and Dosing

Budesonide is an alternative to prednisone or prednisolone for the treatment of inflammatory bowel disease and possibly inflammatory liver disease. This proves his focus on local effects; this makes it an attractive alternative in the treatment of inflammatory bowel disease, with equivalent efficacy to prednisone for dogs.

In dogs, budesonide is less likely to increase liver enzyme activity or cause a stress leukogram. Although the published empirical single dose is 3 mg / m2 per day, it can cause severe polyuria / polydipsia and breathing difficulties in some dogs and can completely suppress the HPA system. Reducing the starting dose (eg 1-2 mg / m2 or 1-2 mcg / 30 kg [dog]; 0.5-0.75 mg [cat]) may be better tolerated and may achieve clinical benefit.

Triamcinolone

The effectiveness of triamcinolone relative to prednisolone varies widely, from 10: 1 to 1: 1; however, in studies in cats with pruritic skin conditions, triamcinolone at one-seventh dose of methylprednisolone (0.18 mg / kg / day orally) showed comparable efficacy (1.41 mg / kg / day orally), suggesting that triamcinolone may be in 7 times more potent than methylprednisolone for cats. This study also showed a lower incidence of polydipsia in cats treated with triamcinolone compared with methylprednisolone, although the number of cats in the study was small.This conclusion is consistent with the understanding that triamcinolone, like dexamethasone, has a substitution ring and removes mineralocorticoid activity.

The potency and efficacy of oral triamcinolone cannot be compared with dexamethasone or prednisolone in dogs. Triamcinolone is more commonly used for long-term injectable use (Vetalog, bi-vetmedica.com) in dogs.

Long Action Injections

Long-acting HA injections provide sustained release by slow dissolution of acetonide and acetate preparations.These GCs are convenient for patients who find it difficult to administer drugs by mouth, but with prolonged use they can lead to suppression of the HPA system and functional insufficiency of the adrenal cortex in stressful situations. For example, triamcinolone acetonide (Vetalog, bi-vetmedica.com) lasts for weeks, and a single injection can suppress adrenal function in dogs for up to 4 weeks.

Like oral HA, these HA injections can lead to debilitating side effects that are more complicated due to the long duration of action.

Both triamcinolone acetonide and methylprednisolone acetate (Depomedrol, henryschein.com) can cause congestive heart failure in sensitive cats. This is due to an increase in plasma volume of up to 40% in cats during the first week after HA administration. This is secondary to osmotic shifts between cellular and plasma components.

These long-acting GCs should be avoided in patients with heart failure and should only be used with educated clients and close clinical monitoring of patients with murmurs.

Similarly, methylprednisolone acetate increases blood glucose levels in cats and can cause diabetes. Any cat treated with HA – especially with long-acting drugs – should be closely monitored for polydipsia, weight loss, glucosuria, or elevated serum fructosamine levels.

Bacteriuria without clinical signs develops in about 20-40% of dogs with chronic treatment with HA; females are more susceptible than males.Bacteriuria is visible even after a single treatment, and monitoring only urine sediment is unreliable because half of the positive cultures are absent in pyuria in dogs treated with HA. However, it is clear that people do not support treatment for asymptomatic bacteriuria, even in immunocompromised patients. Therefore, intermittent urine cultures are probably not indicated in the treatment of dogs and cats with HA unless signs of urinary tract abnormality are found.

Source: https: // vk.com / doc180197187_438000583? hash = 7feb930d4e7f90b5bd & dl = dc9688e

1a753d

90,000 What are we being treated with: Prednisolone. Purchases that we have lost

Prednisolone can also be prescribed for renal diseases, when the adrenal glands’ own hormones for some reason do not perform their functions properly. For example, in nephrotic syndrome, when proteins that should not be there enter the urine, people are at risk of serious infections, and Prednisolone can reduce this risk and reduce the likelihood of a return of the disease (which can be caused by a new viral infection), but longer regimens application, than two or three months, did not justify themselves in any way (and well, the less side effects).With inflammation of the shoulder joint, Prednisolone can save you from pain, but with gout, which has a completely different mechanism of occurrence, hope is weak – you will have to change your lifestyle.

Prednisolone is often used in the treatment of eye infections and cataract surgery to help protect the eyes from inflammation, but whether it is better than NSAIDs is unknown.

But in colitis, the benefits of corticosteroids do not always outweigh their harm, although in Crohn’s disease they help to trigger remission.

The power of corticosteroids also extends to neurological inflammations: for example, nerve endings damaged by leprosy are successfully treated, although with prolonged or weak dysfunction, the benefits of these drugs are no longer obvious. Muscle functions are slightly improved in patients with Duchenne dystrophy (although in the long term, the ratio of risks and benefits is still in question), but in Guillain-Barré syndrome, significant effectiveness of the drug has not been proven. The problem is the same with multiple sclerosis in the long term: so far research does not allow for recommendations.

Indicator.Ru recommends: you can, only carefully

Despite the fact that the drug has a lot of studies on a small number of patients (which makes them statistically weak), its mechanism of action is known – after all, prednisolone belongs to glucocorticoid hormones that work in the body for sure.

ARVI treatment regimen with suspected or confirmed COVID-19

If you are sick on the 1-3rd day, immediately start taking ALL of the drugs listed below according to five points:

1.One of the antiviral drugs: Ingavirin 90 mg 1 ton in the morning 7 days or Arbidol 200 mg * 4 r per day or favipravir according to the scheme or triazaverine according to the instructions or Kagocel according to the scheme. To these drugs, you need to add drops of influenza (interferon alpha), 3 drops in each nasal passage * 5 times a day, 7 days or Viferon in suppositories of 500 thousand units. * 2 times a day – 7 days.

2. Antipyretic drugs: paracetamol 0.5, 1 tab. up to 4 times a day with fever over 38 grams, can be combined with ibuprofen 400 mg * 3 times a day or with aspirin 0.5 * 3 times a day
3. Bromhexine 8 mg 4r per day or Ambroxol 1 ton 4r (expectorant , also blocks the entry of the virus into the cell), 2 weeks.
4. Veroshpiron 50 mg in the morning – 2-3 weeks (considered a weak diuretic, but in this case it is used to lower testosterone, blockade of ARA 2 receptors on which the virus sits, reduce pulmonary fibrosis, so that there are no complications after an infection, shortness of breath)
5. Blood thinners (because coronavirus causes inflammation of small vessels and blood clots form in them) – anticoagulants – eliquis 2.5 mg * 2p or xarelto 10 mg (15 mg, 20 mg) in the morning – 3-4 weeks.It is necessary to start using them as early as possible !!! If it is not possible to purchase these drugs, you can start taking curantil or dipyridamole 75 mg * 2 times a day (improves microcirculation, for the prevention of blood clots) + aspirin 500 mg ¼ tablet after dinner.
   The duration of treatment, if there is no worsening of the condition, is 2 weeks, then bromhexine, verospiron and blood thinners can be canceled.
   If your temperature persists or increases for 4-5 (or more) days of illness, shortness of breath, cough appears … you need to ADD the following drugs to treatment:
6. Anti-inflammatory hormonal drugs dexamethasone 0.5 mg, 3-4 tablets.per day or metipred (methylprednisolone) 4 mg, 3-4 tablets. per day or prednisolone 5 mg table 4. per day, take in two doses (morning, day), strictly after meals, for about 7 days, then gradually reduce the dose by 0.5 (half) tablets 1 time in 3-5 days (the slower, the better) until complete cancellation …
7. Increase the dose of anticoagulants – eliquis to 5 mg * 2p or xarelto to 20 mg in the morning for 2 weeks, then reduce the dose only by agreement with the doctor.
8. As anti-inflammatory drugs irritate the gastric mucosa, it is necessary to start taking the following drugs:

• famotidine 40 mg at night or nolpaza 0.02 or omeprazole 0.02 1 ton * 2 times a day for the entire period while taking hormones)

2. we add antibacterial therapy: azithromycin (sumamed) 500 mg once a day for 5 days or amoxiclav (flemoklav) 500 mg, 1 tab.3 times a day for 7-10 days or levofloxacin 500 mg, 1 tab. 2 times a day for 7 days or another antibiotic. The possibility of issuing a prescription can be agreed upon by the specified phone number or with account. a doctor.
   If the condition improves, then this treatment (except for antibiotics) is continued for up to 3 weeks.

Perhaps on the 5-7th day of illness, the appearance or intensification of shortness of breath, fever, deterioration of the general condition – more intensive therapy is needed, you should call the doctor, tel .: 89517340922, 89517341137.
Additionally, from the first days of the disease, within 14 days, and if necessary, even longer, you can take:

• vitamin D (aquadetrim or vigantol) 8-10 drops per day (help the body fight the virus, with a viral infection there is a very strong vitamin D deficiency, who drinks, the infection is easier)
• zinc preparations 15-50 mg per day (help the body fight the virus)
• vitamin C 500 mg per day for up to 1 month.

90,000 28 reviews, instructions for use

Simultaneous administration of prednisolone with inducers of hepatic microsomal enzymes (phenobarbital, rifampicin, phenytoin, theophylline, ephedrine) leads to a decrease in its concentration.

Simultaneous administration of prednisolone with diuretics (especially thiazide and carbonic anhydrase inhibitors) and amphotericin B can lead to increased excretion of potassium from the body.

Simultaneous administration of prednisolone with sodium-containing drugs leads to the development of edema and increased blood pressure.

Simultaneous administration of prednisolone with amphotericin B increases the risk of developing heart failure.

Simultaneous administration of prednisolone with cardiac glycosides impairs their tolerability and increases the likelihood of ventricular premature beats (due to hypokalemia).

Simultaneous administration of prednisolone with indirect anticoagulants – prednisolone enhances the anticoagulant effect of coumarin derivatives.

The simultaneous administration of prednisolone with anticoagulants and thrombolytics increases the risk of bleeding from ulcers in the gastrointestinal tract.

Simultaneous administration of prednisolone with ethanol and NSAIDs increases the risk of erosive and ulcerative lesions in the gastrointestinal tract and the development of bleeding (in combination with NSAIDs in the treatment of arthritis, it is possible to reduce the dose of glucocorticosteroids due to the summation of the therapeutic effect).

Simultaneous administration of prednisolone with paracetamol increases the risk of hepatotoxicity (induction of liver enzymes and the formation of a toxic metabolite of paracetamol).

The simultaneous administration of prednisolone with acetylsalicylic acid accelerates its excretion and reduces the concentration in the blood (when prednisolone is withdrawn, the level of salicylates in the blood increases and the risk of side effects increases).

Simultaneous administration of prednisolone with insulin and oral hypoglycemic drugs, antihypertensive drugs reduces their effectiveness.

Simultaneous administration of prednisolone with vitamin D reduces its effect on the absorption of Ca ²⁺ in the intestine.

Simultaneous administration of prednisone with growth hormone reduces the effectiveness of the latter, and with praziquantel – its concentration.

Simultaneous administration of prednisolone with m-anticholinergics (including antihistamines and tricyclic antidepressants) and nitrates increases intraocular pressure.

Simultaneous administration of prednisolone with isoniazid and mexiletine increases the metabolism of isoniazid, mexiletine (especially in “fast” acetylators), which leads to a decrease in their plasma concentrations.

Concomitant administration of prednisolone with carbonic anhydrase inhibitors and amphotericin B increases the risk of osteoporosis.

The simultaneous appointment of prednisolone with indomethacin – displacing prednisolone from the connection with albumin, increases the risk of developing its side effects.

Simultaneous administration of prednisolone with ACTH enhances the effect of prednisolone.

Simultaneous administration of prednisolone with ergocalciferol and parathyroid hormone prevents the development of osteopathy caused by prednisolone.

Simultaneous administration of prednisolone with cyclosporine and ketoconazole – cyclosparin (inhibits metabolism) and ketoconazole (decreases clearance) increases toxicity.

The appearance of hirsutism and acne is facilitated by the simultaneous use of other steroid hormonal drugs (androgens, estrogens, anabolic steroids, oral contraceptives).

The simultaneous administration of prednisolone with estrogens and oral estrogen-containing contraceptives reduces the clearance of prednisolone, which may be accompanied by an increase in the severity of its therapeutic and toxic effects.

Simultaneous administration of prednisolone with mitotane and other inhibitors of adrenal cortex function may necessitate an increase in the dose of prednisolone.

When used simultaneously with live antiviral vaccines and against the background of other types of immunization, it increases the risk of virus activation and the development of infections.

With the simultaneous use of prednisolonas with antipsychotics (neuroleptics) and azathioprine, the risk of developing cataracts increases.

Simultaneous administration of antacids reduces the absorption of prednisolone.

With simultaneous use with antithyroid drugs decreases, and with thyroid hormones increases the clearance of prednisolone.

When used simultaneously with immunosuppressants, the risk of developing infections and lymphoma or other lymphoproliferative disorders associated with the Epstein-Barr virus increases.

Tricyclic antidepressants can increase the severity of depression caused by taking glucocorticosteroids (not indicated for the treatment of these side effects).

Increases (with prolonged therapy) the content of folic acid.

Hypokalemia caused by glucocorticosteroids can increase the severity and duration of muscle block in the presence of muscle relaxants.

In high doses it reduces the effect of somatropin.

Allergic cough – Dialogue online pharmacy

Allergic cough is the main symptom of respiratory allergies, which in recent years have acquired not only medical but also social significance.The prevalence of pathology is growing due to the deteriorating environmental conditions of the population, there is a steady tendency towards an aggravation of the clinical manifestations of the disease, especially in childhood.

Allergic cough: symptoms

Allergic cough is the main symptom of diseases based on an allergic component.
Coughing is a complex reflex act that has a protective role for the airways. With its help, excess mucus produced by the cells of the bronchial mucosa and all foreign substances: microorganisms, dust particles, smoke and others are removed from the respiratory tract.
Respiratory allergies are formed against the background of increased sensitivity of the respiratory mucosa to heterogeneous agents (allergens) that enter the bronchi along with the air.

Distinguish between allergies:

The nature of an allergic cough varies. This is due to the location of the sensitized area in the respiratory system.

With allergic pharyngitis, a sore throat appears first, then a dry, annoying unproductive cough without phlegm.
Allergic tracheitis is characterized by a strong, sometimes vomiting, dry, paroxysmal cough. There is pain behind the breastbone.

If the vocal cords are affected, signs of laryngotracheitis develop with a “barking” rough cough.

Allergic bronchitis resolves with symptoms of bronchospasm. Whooping cough, dry at first, soon becomes moist. After a coughing fit, thick viscous sputum leaves, breathing is restored.

In bronchial asthma, paroxysmal cough with signs of suffocation, difficulty exhaling, wheezing, audible from a distance.Cyanosis of the nasolabial triangle, shortness of breath. The accessory muscles of the chest and abdomen are involved in the act of breathing.

How to Distinguish Allergic Cough

It is possible to distinguish an allergic cough from a cough associated with other respiratory diseases, possibly by its characteristic features.
Allergy-weighted heredity.
An obsessive dry cough appears unexpectedly without signs of inflammation of the respiratory tract: there are no symptoms of intoxication and catarrhal phenomena – fever, headache, redness in the throat.
In the history of the disease, information about the previous sensitization of the body: atopic dermatitis, hay fever.

A frequent combination of cough with other manifestations of allergies: skin rash, itching, redness of the eyes, watery eyes, profuse discharge from the nose.

Allergic cough: diagnosis

Diagnosis of allergic cough is based on an analysis of the medical history, the search for factors predisposing to allergies (identification of allergens) and laboratory data.
In the analysis of peripheral blood – eosinophilia.
To confirm the allergic nature of the cough, special studies are performed:
Children under 5 years old and adults with skin manifestations of allergies and with recurrent respiratory allergies are tested in vitro (in glass), that is, in the laboratory: determination of specific IgE, mast cell degranulation reaction.
The rest of adults and children over 5 years of age do skin tests with non-infectious, infectious and fungal allergens.

For food allergies, it is mandatory to keep a food diary and prescribe elimination-provocative tests with food.

Allergic cough in an adult

An allergic cough in an adult occurs only in the presence of an allergen. After the termination of contact with the provoking factor, the cough stops.

The following can act as an allergen:

1. Household dust.
2. Household chemicals.
3. Animal wool.
4. Medicines.
5. Perfumery.
6. Plant pollen.
7. Tobacco smoke.
8. Industrial hazards.

Prolonged contact with an allergen that causes an allergic cough creates an increased sensitivity not only to this allergen, but also to many other foreign substances (cross-allergy). In such cases, it can be difficult to identify the primary allergen that triggered the pathological reaction in the body.

Attacks of an allergic cough intensify, become painful, the normal rhythm of a person’s life is disrupted: he suffers from insomnia, against this background, he has lethargy, weakness, memory impairment, and decreased ability to work.

Allergic cough in a child

A provocateur (allergen) of an allergic cough in a young child is most often a food allergy, that is, an increased sensitivity to a certain food product.
Food allergens:

1. cow’s milk;
2. eggs;
3. chocolate;
4. wheat;
5. nuts;
6. meat;
7. a fish.

Acute laryngitis is especially dangerous for a child, which, due to the anatomical and physiological features of the structure of the larynx in children, can lead to false croup – edema of the vocal cords, spasm of the larynx. The attack begins suddenly late in the evening or at night. The child is frightened, he does not have enough air, his voice disappears or becomes hoarse, breathing is noisy, when inhaling, the intercostal spaces, the jugular and subclavian fossa are drawn in. Cyanosis of the lips appears, the limbs are cold.The condition is a medical emergency.

Allergic cough: treatment for adults and children

The main objectives of the treatment:

1. Elimination of the causative factor causing an attack of allergic cough.
2. In case of pollen allergy during flowering of plants – moving to another climatic zone.
3. With food – a strict diet with the exclusion of potential allergens.
4. In case of occupational hazards – a change of job.
5. Timely treatment of a chronic infection in the body: chronic tonsillitis, pharyngitis, sinusitis and others.
6. Reducing the negative impact on the respiratory tract of various irritants – cold air, tobacco smoke, exhaust gases.

Principles of drug therapy:

Bronchospastic drugs; adrenomimetics, anticholinergics, phosphodiesterase antagonist.

1. Histamine H1 receptor blockers.
2. Drugs that lower the reactivity of the bronchi.
3. Expectorants.

Inhalation for allergic cough

Inhalation for allergic cough is the most effective way of delivering a drug to the zone of greatest sensitivity of the respiratory tract. Spraying of medicinal substances to aerosols occurs using a nebulizer apparatus. The big advantage of this method is the use in the treatment of smaller doses of drugs.
Medicines used for inhalation:

• Pulmicort – suspension for inhalation with steroids, quickly relieves swelling, is effective in bronchial asthma.
• Berodual is a bronchodilator, used only in inhalation.
• Inhalations are done in a course of 5-10 days, 2-3 times a day during a prolonged dry cough.
• After inhalation, it is advisable to refrain from eating and drinking for an hour.

It is strictly forbidden to do steam hot inhalations with an allergic cough, as this may result in a burn of mucous membranes, an increase in edema, and spasm of the larynx.

Allergic cough medicine

Antihistamines prevent the release of histamine and reduce the sensitivity of the respiratory tract to allergens: Tavegil , Erius , Cetrin .

1. Bronchodilators, expanding the lumen of the bronchi, relieving spasm: Euphyllin , Salbutamol , Berotek .
2. Mucolytics that thin sputum: Acetylcysteine ​​ (ACC), Ribonuclease, Mucaltin , Fluimucil .
3. Centrally acting agents that block the cough center: Sinekod , Libeksin .
4. Glucocorticoids for status asthmaticus: Prednisolone , Hydrocortisone , Dexamethasone .

Folk remedies for allergic cough

Allergists do not recommend using folk remedies for allergic cough.

This is due to several factors:

Lack of reliable scientific research on the benefits and effectiveness of this method of treatment.
In allergology, there is such a thing as cross-allergy. Even if the medicinal plant is not a provoking allergen, similar components in it will cause allergies.
Folk remedies of animal and plant origin have an allergenic effect, and they themselves are capable of starting the allergic process.
It is especially dangerous to use in the treatment of plants purchased in spontaneous markets from random sellers. Such “healing herbs” may contain pesticides, heavy metals, radionucleides.

Recommendations

People suffering from any type of allergy need to follow the rules of maximum hyposensitization in everyday life in order to eliminate possible allergens.
Fighting dust – daily wet cleaning of the apartment, freeing the premises from “dust collectors”: carpets, blankets, soft toys.It is advisable to purchase a vacuum cleaner with anti-allergic filters.
If there is an allergic person in the house, you will have to give up pets (dogs, cats, fish, birds) and houseplants.

Apply cosmetics with caution after preliminary testing.

Question-answer

Is it possible to do inhalations with an allergic cough?

Inhalations for allergic coughs are, especially with the help of modern devices – nebulizers, one of the most effective methods of treatment.The properties of nebulizers are to transform medicinal solutions into fine mixtures – aerosols that easily penetrate deep into the bronchi.

Is it possible with an allergic cough in the pool

Water procedures, including swimming in the pool, are not a contraindication for allergic coughs. Conversely, high humidity has a beneficial effect on dry mucous membranes of the respiratory tract, unless the patient is hypersensitive to the chemicals used to purify water.

Is it possible to drink with an allergic cough Sinekod

Sinekod refers to centrally acting antitussive drugs, that is, it directly blocks the cough center in the central nervous system. It is prescribed to both children (drops, syrup) and adults with a dry, painful cough, including those of an allergic nature.

Is it possible to lose consciousness with an allergic cough?

In severe forms of allergic cough (laryngotracheitis, bronchial asthma), when symptoms of respiratory failure develop, oxygen starvation of the brain occurs in the absence of emergency care, a person can lose consciousness.

Results

Allergic cough sometimes appears as a harbinger of other allergic pathologies. Patients with allergic cough should be monitored by a pulmonologist and allergist, follow all medical recommendations and prescribed examinations. Allergy is an inadequate response of the immune system to the action of internal and external stimuli. If treatment is neglected, the disease can turn into bronchial asthma.

Memorial Sloan Kettering Cancer Center

This document, provided by Lexicomp ^® , contains all the information you need to know about the drug, including the indications, route of administration, side effects, and when you should contact your healthcare provider.

Trade names: USA

Korlym; Mifeprex

Warning

When used to terminate a pregnancy:

• In rare cases, after any type of termination of pregnancy, very serious infections, bleeding or other complications may develop. This may also be possible after using this drug to terminate a pregnancy. Sometimes these complications can be deadly.
• Make sure you know who to contact and what to do in an emergency.These measures include arriving at an emergency room if your doctor cannot be reached. Call your doctor right away if you have persistent fever, severe abdominal pain, tachycardia, heavy vaginal bleeding that does not go away, or fainting.
• If this drug does not induce a complete abortion, surgery may be required for a complete abortion. Make sure you understand what the drug is, what it is for, how to take it, and when to see your doctor again.You must consent to the abortion and surgery if required. You must read the instructions for use of the drug and sign the patient consent form.
• Bring the instructions for use with you if you go to the emergency room or other doctor.
• If this drug does not work within 2 days, your doctor may prescribe another drug for you. If you have symptoms such as abdominal pain, weakness, nausea, vomiting, or diarrhea more than 24 hours after taking another drug, see your doctor right away.

When used to lower blood sugar:

• Use during pregnancy will cause fetal loss.
• Not for use by pregnant women. Before you start taking this drug, you will have a pregnancy test to confirm that you are NOT pregnant. Use a non-hormonal birth control while you are taking this drug and for 1 month after you stop taking this drug. Consult your doctor.
• If you stop taking this drug for more than 14 days, you should get another pregnancy test.Consult your doctor.

What is this drug used for?

• Used to terminate pregnancy.
• Used to lower blood sugar levels in patients with Cushing’s syndrome.

What do I need to tell my doctor BEFORE taking this drug?

When used to terminate a pregnancy:

• If you are allergic to this drug, any of its ingredients, other drugs, foods or substances.Tell your doctor about your allergy and how it manifested itself.
• If you have any of the following conditions: adrenal insufficiency, bleeding, or porphyria.
• If you have an ectopic pregnancy (ectopic pregnancy).
• If you have an intrauterine device (IUD) installed.
• If you are unable to follow the doctor’s instructions regarding treatment to terminate your pregnancy or get to the emergency room yourself if necessary.
• If the pregnancy is more than 10 weeks.
• Individuals who find it difficult to understand or comply with the Patient-Therapist Agreement.
• If you have a tumor in your ovary, fallopian tube, or around these organs.
• If you are taking anticoagulants (to thin the blood) or long-acting steroids such as prednisone.

When used to lower blood sugar:

• If you are allergic to this drug, any of its ingredients, other drugs, foods or substances.Tell your doctor about your allergy and how it manifested itself.
• If you have any of the following health problems: changes in the cells lining the uterus, endometrial cancer, or if you have ever had vaginal bleeding for an unknown reason.
• If you do not have Cushing’s syndrome.
• If you have any of the following health problems: liver disease or low potassium levels.
• If you are taking anticoagulants (to thin the blood) or long-acting steroids such as prednisone.
• If you are taking any drugs (prescription and over-the-counter, natural products, and vitamins) that should not be taken with this drug, such as certain medicines to treat high cholesterol, migraines, or mood disorders. There are many medicines that should not be taken at the same time as this medicine.

This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.

Tell your doctor and pharmacist about all the medicines you take (both prescription and over-the-counter, natural products and vitamins) and your health problems. You need to make sure that this drug is safe for your medical conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s approval.

What do I need to know or do while taking this drug?

When used to terminate a pregnancy:

• Tell all healthcare providers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
• Consult a healthcare professional if you frequently drink grapefruit juice or eat grapefruit.
• You can become pregnant immediately after termination of pregnancy.If you do not want to get pregnant again, start using reliable contraception immediately after terminating your pregnancy or before resuming sexual activity.
• Vaginal bleeding or spotting that lasts 9-16 days usually occurs after using this drug. Sometimes such phenomena lasted up to 30 days. See your doctor immediately if you have vaginal bleeding for the above period, if you have heavy, persistent vaginal bleeding, or if you have vaginal bleeding concerns.
• Tell your doctor if you are breastfeeding. It is necessary to consult if the drug poses any risk to the child.

When used to lower blood sugar:

• Tell all healthcare providers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
• Perform blood tests as directed by your healthcare practitioner. Please consult your doctor.
• Do not consume grapefruit or grapefruit juice.
• Birth control pills and other hormonal contraceptives may not be effective enough to prevent pregnancy. Also use a contraceptive such as a condom during treatment and for 1 month after your last dose.
• If you become pregnant while taking this drug or within 1 month after your last dose, call your doctor right away.
• Tell your doctor if you are breastfeeding. It is necessary to consult if the drug poses any risk to the child.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, some people with this drug can have serious and sometimes deadly side effects. Call your doctor or doctor right away if you have any of the following signs or symptoms, which may be associated with serious side effects:

When used to terminate a pregnancy:

• Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.
• Signs of infection, such as fever, chills, very bad sore throat, ear, or sinuses, cough, increased or discolored phlegm, pain when urinating, mouth ulcers, or sore that does not heal.
• Profuse bleeding (2 pads are soaked per hour).
• Severe abdominal pain.
• Severe diarrhea.
• Severe vaginal irritation.
• Pelvic pain.
• Rapid heartbeat.

When used to lower blood sugar:

• Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.
• Signs of low potassium, such as muscle pain or weakness, muscle cramps, or a feeling of an irregular heartbeat.
• Signs of high or low blood pressure, such as very severe headache or dizziness, fainting, or vision changes.
• Signs of adrenal dysfunction such as severe nausea and vomiting, severe dizziness or loss of consciousness, muscle weakness, feeling very tired, mood changes, lack of appetite, or weight loss.
• Abnormal vaginal bleeding.
• Anxiety.
• Pain or pressure in the chest.
• Shortness of breath.
• Swelling of the hands or feet.
• Sleep disorders.
• Blood sugar may decrease. This effect may be increased when this drug is used with other diabetes drugs. Symptoms may include dizziness, headache, drowsiness, feeling weak, tremors, tachycardia, confusion, hunger, or sweating. Call your doctor right away if any of these signs occur. If your blood sugar drops, follow the directions for this condition.Such directions may include taking tablets or glucose solution and some fruit juices.
• Some type of heart rhythm disorder (prolonged QT interval) may happen with this drug. See your doctor right away if you have tachycardia, irregular heartbeat, or fainting.

What are some other side effects of this drug?

Any medicine can have side effects. However, many people have little or no side effects.Call your doctor or get medical help if these or any other side effects bother you or do not go away:

When used to terminate a pregnancy:

• Feeling dizzy, tired, or weak.
• Headache.
• Abdominal pain or diarrhea.
• Nausea or vomiting.
• Stomach colic.
• Vaginal discharge.

When used to lower blood sugar:

• Feeling dizzy, sleepy, tired, or weak.
• Headache.
• Constipation, diarrhea, abdominal pain, nausea, vomiting, or decreased appetite.
• Dry mouth.
• Heartburn.
• Pain in the back, muscles or joints.
• Irritation of nose or throat.

This list of potential side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Office.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your healthcare practitioner. Read all the information provided to you. Follow all instructions strictly.

When used to terminate a pregnancy:

• To terminate your pregnancy, you will need to take this drug at the same time as another drug, misoprostol.You need to know exactly when and how to take misoprostol after taking this drug. If you have questions, ask your doctor or pharmacist.
• Most abortions occurred within 2-24 hours after misoprostol was taken. During this time, you will experience bleeding and cramping, which is most likely to be heavier than your regular period. Misoprostol should be taken in the right place to keep you ready.If you have any questions, consult your doctor.
• Follow your doctor’s instructions.

When used to lower blood sugar:

• Take with food.
• Swallow whole. Do not chew, break, or crush.
• Consult your doctor if you have difficulty swallowing.
• Continue taking this drug as directed by your doctor or other healthcare professional, even if you feel well.

What to do if a dose of a drug is missed?

When used to terminate a pregnancy:

• Call your doctor for further instructions.

When used to lower blood sugar:

• Take the missed dose as soon as you can.
• If it is time for your next dose, do not take the missed dose and then return to your normal dose.
• Do not take 2 doses at the same time or an additional dose.

How do I store and / or discard this drug?

When used to terminate a pregnancy:

• If you need to store this drug at home, ask your doctor, nurse, or pharmacist for information about how to store it.

When used to lower blood sugar:

• Store at room temperature in a dry place.Do not store in the bathroom.

All forms of issue:

• Store all medicines in a safe place. Keep all medicines out of the reach of children and pets.
• Dispose of unused or expired drugs. Do not empty into toilet or drain unless directed to do so. If you have any questions about the disposal of your medicinal products, consult your pharmacist.Your area may have drug recycling programs.

General information about medicines

• If your health does not improve or even worsens, see your doctor.
• Do not give your medicine to anyone or take other people’s medicines.
• Some medicines may come with other patient information sheets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
• A separate patient instruction sheet is attached to the product. Please read this information carefully. Reread it every time you replenish your supply. If you have questions about this drug, talk with your doctor, pharmacist, or other healthcare professional.
• If you think an overdose has occurred, call a Poison Control Center immediately or seek medical attention. Be prepared to tell or show which drug you took, how much and when it happened.

Consumer use of information and limitation of liability

This information should not be used to make decisions about taking this or any other drug. Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are suitable for a particular patient. This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient.Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug. This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional. Check with your doctor for complete information on the possible risks and benefits of taking this drug.Use of this information is governed by the Lexicomp End User License Agreement available at https://www.wolterskluwer.com/en/solutions/lexicomp/about/eula.

Copyright

© UpToDate, Inc. and its affiliates and / or licensors, 2021. All rights reserved.

90,000 What to put into the inhaler – articles Dr. Elephant

It is believed that inhalations are more effective than syrups and tablets. During the procedure, the medicinal solution is converted into an aerosol or vapor – this is how the drug directly affects the inflammation focus.

Today we will analyze which medicinal and non-medicinal solutions can be used in inhalers.

Medicines

Prescribed individually at a doctor’s appointment. As well as other details of the treatment – how often to inhale and how much drug to pour into the inhaler.

Pulmonologists identify 5 groups of drugs that can be used for inhalation.

1. Bronchodilators – relieve bronchospasm, are used in the treatment of bronchial asthma, chronic obstructive pulmonary disease and some other diseases.For example: salbutamol, fenoterol, berodual.
2. Non-steroidal anti-inflammatory drugs – Reduce pain, fever and inflammation. For example: pulmicort and cromohexal.
3. Antibiotics – Used to treat bacterial infections. For example: fluimicil.
4. Corticosteroids are steroidal anti-inflammatory drugs. For example: hemisuccinate, prednisolone, dexamethasone.
5. Mucolytics – thin the phlegm and facilitate its excretion from the lungs.For example: fluimucil, lazolvan, ambroxol, ambrohexal, pulmozyme, acetylcysteine.

Not many drugs can be used with steam inhalers and ultrasonic nebulizers: for example, antibiotics and hormones are destroyed when heated.

If you need a universal option, and you know exactly what to pour into the inhaler when you cough, choose compressor and mesh nebulizers – you can use any drugs with them.

Saline

This compound of water and 0.9% sodium chlorine is physiological – the same concentration of sodium chlorine is found in blood plasma.Therefore, saline can be poured into the inhaler even for a child.

During inhalation, saline relieves irritation and swelling of the mucous membrane, promotes the discharge of sputum. It can be made at home from table salt and distilled water.

The mineral water of Borjomi or Essentuki is considered an analogue of saline, but manufacturers do not recommend using them – the composition may contain suspensions that are not physiological.

Essential oils

Useful for the prevention of ARVI and influenza. Essential oils can only be poured into steam inhalers – for the prevention and treatment of the upper respiratory tract.