Abstract
Glucocorticoids (GCs) are among the most widely used class of drugs for the treatment of atopic diseases. Their efficacy in the atopic diseases comes from their broad anti-inflammatory and immunosuppressive effects. Systemic glucocorticoids are most often used as rescue therapy for acute asthma exacerbations and can be given orally, intravenously, or intramuscularly, while oral-inhaled GCs are considered first-line controller agents for all patients with persistent asthma, and intranasal GCs are recommended in the treatment of rhinitis. In the half century since their initial synthesis and subsequent use in asthma, a vast body of clinical experience has accumulated with great strides made in our understanding of how GCs act at both the molecular and cellular levels. In addition, we also have good understanding of their potential for adverse effects. This chapter will provide a broad overview of the structure, mechanisms of action, pharmacokinetics, efficacy, adverse effects, and current issues associated with both systemic and inhaled GC therapy in asthma, in addition to intranasal GC therapy for the treatment of allergic rhinitis.
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Bibliography
Agertoft L, Pedersen S. Effect of long-term treatment with inhaled budesonide on adult height in children with asthma. N Engl J Med. 2000;343:1064.
The Childhood Asthma Management Program Research Group. Long-term effects of budesonide or nedocromil in children with asthma. N Engl J Med. 2000;343:1054.
Bacharier LB, Guilbert TW, Zeiger RS, et al. Patient characteristics associated with improved outcomes with use of an inhaled corticosteroid in preschool children at risk for asthma. J Allergy Clin Immunol. 2009;123:1077.
Ducharme FM, Lemire C, Noya FJD, et al. Preemptive use of high-dose fluticasone for virus-induced wheezing in young children. N Engl J Med. 2009;360:339.
Guilbert TW, Morgan WJ, Zeiger RS, et al. Long-term inhaled corticosteroids in preschool children at risk for asthma. N Engl J Med. 2006;354:1985.
Harris JB, Weinberger MM, Nassif E, et al. Early intervention with short courses of prednisone to prevent progression of asthma in ambulatory patients incompletely responsive to bronchodilators. J Pediatr. 1987;110:627.
Kelly WH, Sternberg AL, Lescher R, et al. Effect of inhaled glucocorticoids in childhood on adult height. N Engl J Med. 2012;367:904.
Nave R, Fisher R, McCracken N. In vitro metabolism of beclomethasone dipropionate, budesonide, ciclesonide, and fluticasone propionate in human lung precision-cut tissue slices. Respir Res. 2007;8:65.
Panickar J, Lakhanpaul M, Lambert PC, et al. Oral prednisolone for preschool children with acute virus-induced wheezing. N Engl J Med. 2009;360:329.
Suissa S, Ernst P, Benayoun S, et al. Low dose inhaled corticosteroids and the prevention of death from asthma. N Engl J Med. 2000;343:332.
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Spahn, J.D. (2016). Glucocorticoids. In: Mahmoudi, M. (eds) Allergy and Asthma. Springer, Cham. https://doi.org/10.1007/978-3-319-30835-7_39
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DOI: https://doi.org/10.1007/978-3-319-30835-7_39
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