side effects from inhaled steroids
adva...@my-dejanews.com
or high dose (total of six inhales daily at 200 mcg per dose). I am persuaded
that asthma damages airways in the long run without steroids. I do even
better on eight inhales (four twice daily). SHORT TERM SIDE EFFECTS: I don't
know if these are common effects. I get leg cramps. My feet seem painful
sometimes when I stand up for a long time. But cramps seem to run in my
family and lots of people have sore feet. It seems a lot worse -- could it be
Pulmicort? LONG TERM SIDE EFFECTS: these sound ominous, with diabetes,
glaucoma and cataracts, osteoporosis, heading the list. How common are these
in people who don't take oral steriods? How do you watch for them, or help
prevent them? Are any of you with longstanding use of steroids OLD and PRETTY
HEALTHY? I am getting old myself at 55 (asthma reactivated after years of not
having much). Thanks for you input, it's appreciated. DAVID
-----------== Posted via Deja News, The Discussion Network ==----------
http://www.dejanews.com/ Search, Read, Discuss, or Start Your Own
CBI
dose. You are at risk for all the side effects of steroids and should be
extra careful about screening and managing eye problems, bone disease, and
cardiac disease.
--
Good Luck,
CBI, M.D.
powe...@msn.com
adva...@my-dejanews.com wrote in message
<7eqnhp$soa$1...@nnrp1.dejanews.com>...
efle...@usa.net
adva...@my-dejanews.com wrote:
> I use an inhaled steroid -- Pulmicort. I do not know if I am using a
medium
> or high dose (total of six inhales daily at 200 mcg per dose). I am persuaded
> that asthma damages airways in the long run without steroids. I do even
> better on eight inhales (four twice daily). SHORT TERM SIDE EFFECTS: I don't
> know if these are common effects. I get leg cramps. My feet seem painful
> sometimes when I stand up for a long time. But cramps seem to run in my
> family and lots of people have sore feet. It seems a lot worse -- could it be
> Pulmicort? LONG TERM SIDE EFFECTS: these sound ominous, with diabetes,
> glaucoma and cataracts, osteoporosis, heading the list. How common are these
> in people who don't take oral steriods? How do you watch for them, or help
> prevent them? Are any of you with longstanding use of steroids OLD and PRETTY
> HEALTHY? I am getting old myself at 55 (asthma reactivated after years of not
> having much). Thanks for you input, it's appreciated. DAVID
Greater than 3 puffs/day of Pulmicort [200] is considered a High Dose,
per EPR2. Your high dose can start to lead to some of the side effects
of oral steroids if continued long term.
You should be taking steps to minimize your inhaled steroid dose,
such as seeing a good allergy doctor for recommendations. These
could include adding steroid sparing drugs like TheoDur, Serevent,
Singulair; could include allergy testing and steps to reduce your
exposure to allergens; could include evaluation for sinusitis and
GE reflux which can worsen asthma.
A good book on asthma is 'The Asthma Sourcebook', Francis Adams, MD
amazon.com or your bookstore
Ellis
Chefchk
I thought that there were very few side effects from inhaled steroids, as
opposed to oral steroids. My oral steroid dose has been going down and my
inhaled steroid use going up - I was happy about it. Maybe I shouldnt be?
Life is uncertain - eat dessert first.
Nancy
8=: )
Starwind
>
>I thought that there were very few side effects from inhaled steroids, as
They do. As you said, it is a relative thing, though. And the higher
the inhaled steroid dose the more side effects there are a risk of.
But even a high dose inahled steroid has fewer side effects than
fairly low-dose oral steroids.
Inhaled steroids primarily act in the lungs, whereas to get the same
effect oral steroids must go thorugh your entire body [therefore you
need more oral steroids to get the same effect as inhaled steroids],
which is why they are so problematic -- the side effects to be really
concerned about generally are takingplace somewhere else in the body
other than the lungs.
Some of the dose of inhaled steroids gets absorbed into one's
bloodstream, but the amount is very small, and at low doses usually is
not even measurable. At higher doses, the level in one's blood is
measurable, and can be sufficient to cause systemic effects, just the
same as an oral steroid dose that has the same bloodstream levels can.
Say that 1600 mcg/d of Pulmicort gives you the same *systemic* levels
of steroids as 5 mg of prednisone does [I am not sure of the dose
comparison here, but I think it is somewhere near here; someone else
who knows for sure can supply the correct numbers]. Well, if you are
taking 10 mg of pred a day and taking 1600 mcg of pulmicort gets you
off pred, then you have a net benefit, right? Even if it got you down
to 5 mg pred you still might be saving some side effects [because the
pulmicort probably has more lung action at that level than the pred
does].
>opposed to oral steroids. My oral steroid dose has been going down and my
>inhaled steroid use going up - I was happy about it. Maybe I shouldnt be?
You should be happy with it. Just be aware that inhaled steroids are
not without potential side effects.
SW.
THIS IS NOT MEDICAL ADVICE.
Colleen Allen
>I use an inhaled steroid -- Pulmicort. I do not know if I am using a medium
>or high dose (total of six inhales daily at 200 mcg per dose). I am persuaded
>that asthma damages airways in the long run without steroids. I do even
>better on eight inhales (four twice daily). SHORT TERM SIDE EFFECTS: I don't
>know if these are common effects. I get leg cramps. My feet seem painful
>sometimes when I stand up for a long time. But cramps seem to run in my
>family and lots of people have sore feet. It seems a lot worse -- could it be
>Pulmicort? LONG TERM SIDE EFFECTS: these sound ominous, with diabetes,
>glaucoma and cataracts, osteoporosis, heading the list. How common are these
>in people who don't take oral steriods? How do you watch for them, or help
>prevent them? Are any of you with longstanding use of steroids OLD and PRETTY
>HEALTHY? I am getting old myself at 55 (asthma reactivated after years of not
>having much). Thanks for you input, it's appreciated. DAVID
Hello David,
Yes, 1200mcg is considered a high dose of inhaled corticosteroids.
How long have you been taking inhaled steroids? do you take bursts of
systemic steroids too?
The leg cramping might be a sign of an electrolyte imbalance.
I experience foot and leg muscle spasms occasionally as well, usually
during the night. Taking extra calcium is helpful. You should also
have your potassium and magnesium levels checked.
Are you taking any other medication for your asthma? if so what are
you taking?
According to the information found on the following URL's,
"Asthma experts warn against excessive steroid use"
http://www.canoe.ca/HealthNews/980619_asthma.html
". . ."Inhaled steroids are very effective but not universally,"
Chapman told a recent medical debate on patient treatment choices. "It
has long been thought that increasing the dose will obtain more
benefits, but there is a law of diminishing returns.
"Doubling the dose will not reduce symptoms by half." In fact, he
said, an excess of inhaled steroids can be absorbed into the
bloodstream and result in side effects such as cataracts and a loss in
bone density.. . ."
"Cautions: Data is not completely sufficient, but long-term high
doses (>88 mcg/day) of inhaled corticosteroids may be associated with
adverse systemic effects."
According to my records, I have taken 2000mcg (2mg)of Pulmicort
[Budesonide] daily via nebulizer since 1994 and 1600mcg daily from
1990-1994. prior to that I was taking another inhaled corticosteroid
(Beclomethasone) --4 puffs 4 times day.
Side effects I've noted for several years, which I've attribute to
corticosteroid use (Medrol and Pulmicort), are: weight gain, fluid
retension -- abdominal bloating, hypertension, chronic sinus
infections, visual degradation (no sign of cataracts or glaucoma),
short term memory loss, adrenal supression, very fragile (very thin)
skin with loss of fat deposits under skin--causing "peaking effects"
the slightest bump or scrape will cause bruising under the skin and
break-through bleeding.
I was diagnosed (via full PFT) with severe persistent asthma 20 years
ago, at age 37, and diagnosed (via CTscan and full PFT) last year with
moderate emphysema. I also suffer from MCS. And the propellent in
MDI's provoke bronchospasm.
My lung disease has created severe mobility limitations for me. My
airways are very reactive to environmental and chemical pollutants
(fumes such as cigarette smoke, perfumes, hot tar, auto-exhaust etc.,]
Severe shortness of breath (during any exertion) is my primary
symptom. My PEFR (for the last 10 years) has averaged 160 and my FEV1
is 30% of predicted. Besides Pulmicort, I am currently taking Medrol
(tapering), Singulair, Uniphyl, Foradil (Formoterol), Atrovent (via
nebulizer), Salbutamol (via nebulizer), Triazide (Triamterene/HCTZ
(50/25).
FWIW: While taking any type of corticosteroid therapy, don't use salt
or eat salty foods, and if you can't cut out sweets entirely, keep
your sugar intake to a bare minimum. You should also take Calcium and
Magnesium supplements and Vitamin C.
Hope that helps,
Cheers,
Colleen
CBI
whatever dose. I would continue taking the high doses of inhaled until you
are off the oral.
--
Good Luck,
CBI, M.D.
powe...@msn.com
Chefchk wrote in message <19990412105115...@ng-fp1.aol.com>...
>Hi -
>
>I thought that there were very few side effects from inhaled steroids, as
>opposed to oral steroids. My oral steroid dose has been going down and my
>inhaled steroid use going up - I was happy about it. Maybe I shouldnt be?
>
>
free...@netscout.com
adva...@my-dejanews.com wrote:
> I use an inhaled steroid -- Pulmicort. I do not know if I am using a
medium
> or high dose (total of six inhales daily at 200 mcg per dose). I am persuaded
> that asthma damages airways in the long run without steroids. I do even
> better on eight inhales (four twice daily). SHORT TERM SIDE EFFECTS: I don't
> know if these are common effects. I get leg cramps. My feet seem painful
> sometimes when I stand up for a long time. But cramps seem to run in my
> family and lots of people have sore feet. It seems a lot worse -- could it be
> Pulmicort? LONG TERM SIDE EFFECTS: these sound ominous, with diabetes,
> glaucoma and cataracts, osteoporosis, heading the list. How common are these
> in people who don't take oral steriods? How do you watch for them, or help
> prevent them? Are any of you with longstanding use of steroids OLD and PRETTY
> HEALTHY? I am getting old myself at 55 (asthma reactivated after years of not
> having much). Thanks for you input, it's appreciated. DAVID
>
> http://www.dejanews.com/ Search, Read, Discuss, or Start Your Own
>
I am taking a lot of flovent and flonase and I am beginning to be concerned
myself. I have psoriasis ( not bad and in patches at random spots ). When I
am taking prednisone ( an oral steriod ) one pleasant side effect is that the
psoriasis subsides. I am no longer on predisone but I am taking these inhaled
(sniffed) steriods and the psoriasis is still controlled. This leads me to
thinking that I am taking enough flovent/flonase inhaled ( where its supposed
to effect only my lungs ) to have prednisone like effects and that, perhaps
there are other effects that I am not noticing and which might not be so
beneficial. I wrote a few weeks ago about increased anxiety/stress. I am also
concerned about its effect on my diabetes ( I am a mild type II)
LWyremba
problematic side effect, also not all people are equal, there are some
exceptions possible, but very rare. Sometimes there are hoarseness or Soor, but
this is normally no problem.You can combine Pulmicort with formoterol
turbohaler. please ask your physician.
every adaequat oral steroid medication will make much more problems.Lothar
Mary
with it, because he can finally breathe easily (and I don't poke him in
the night and tell him to use his inhaler). He uses 6-8 puffs of
Pulmicort (1200-1600 mcg) daily along with Serevent twice a day (I think
2 puffs each time). He reduces to 6 puffs of Pulmicort when he's feeling
okay, but that usually doesn't last long before he's back to 8 puffs.
So, it's treating the asthma just great! The problem is that he also has
diabetes (he takes Glucatrol). His blood suger has been shooting up like
you wouldn't believe! I'm sure it's from the Pulmicort. His blood suger
is responding as it would to oral steroids.
I keep telling him he needs to be referred to an endocrinologist and
maybe a pulmonologist so they can work out the best combination for him
-- treat his asthma AND keep his blood suger levels low. He's seeing a
family doctor who doesn't seem too concerned about his high blood
readings. I'm talking about going from a high of about 160 (2 hours
after eating) to a high of 300!
Mary
LWyremba wrote:
>
> Normally a high dosis pulmicort (more than 800 - 1600 µg) Turbohaler has no
loki
> with it, because he can finally breathe easily (and I don't poke him in
> the night and tell him to use his inhaler). He uses 6-8 puffs of
> Pulmicort (1200-1600 mcg) daily along with Serevent twice a day (I think
> 2 puffs each time). He reduces to 6 puffs of Pulmicort when he's feeling
> okay, but that usually doesn't last long before he's back to 8 puffs.
>
> So, it's treating the asthma just great! The problem is that he also has
> diabetes (he takes Glucatrol). His blood suger has been shooting up like
> you wouldn't believe! I'm sure it's from the Pulmicort. His blood suger
> is responding as it would to oral steroids.
>
> I keep telling him he needs to be referred to an endocrinologist and
> maybe a pulmonologist so they can work out the best combination for him
> -- treat his asthma AND keep his blood suger levels low. He's seeing a
> family doctor who doesn't seem too concerned about his high blood
> readings. I'm talking about going from a high of about 160 (2 hours
> after eating) to a high of 300!
I think he should indeed see both specialists. I do.
In my case it appears that the Flovent has depressed my adrenal
function somewhat. We're still working on figuring it all out.
Loki
Ellis
>
> I'm concerned about my husband's use of Pulmicort. He's been thrilled
> with it, because he can finally breathe easily (and I don't poke him in
> the night and tell him to use his inhaler). He uses 6-8 puffs of
> Pulmicort (1200-1600 mcg) daily along with Serevent twice a day (I think
> 2 puffs each time). He reduces to 6 puffs of Pulmicort when he's feeling
> okay, but that usually doesn't last long before he's back to 8 puffs.
>
> So, it's treating the asthma just great! The problem is that he also has
> diabetes (he takes Glucatrol). His blood suger has been shooting up like
> you wouldn't believe! I'm sure it's from the Pulmicort. His blood suger
> is responding as it would to oral steroids.
>
> I keep telling him he needs to be referred to an endocrinologist and
> maybe a pulmonologist so they can work out the best combination for him
> -- treat his asthma AND keep his blood suger levels low. He's seeing a
> family doctor who doesn't seem too concerned about his high blood
> readings. I'm talking about going from a high of about 160 (2 hours
> after eating) to a high of 300!
>
Four or more puffs of Pulmicort Turbuhaler (200 ug budesonide)
per day is considered a High Dose. He should be seeing an asthma
doctor, probably pulmonogist, to evaluate why he needs so
much inhaled steroid. Possible aggravating conditions like
sinusitis or GE reflux should be screened for and treated
if present. If allergens or irritants in the air are involved,
they should be minimized. A pulmonologist can also diagnose
the lung condition including whether COPD or other lung
conditions may be involved; inhaled steroids may not be
the proper inhaler for these; Atrovent or Combivent is
often prescribed if there is co-existing COPD.
Side effects of inhaled Pulmicort can be reduced by rinsing
and spitting out after inhaling.
Also make sure he uses the correct technique with the DPI.
This involves breathing out first, then forcefully inhaling
thru the Turbuhaler for as long as it takes, around 3 sec.
in my case. Failure to do this can result in the powder
not reaching the lungs and depositing in the mouth and
throat.
I use Pulmicort, usually 1 pf twice a day. Also Serevent
and Intal, plus low dose theophylline and Singulair.
Here's a link:
http://aadmc.org/inthenews/news/inhaled_steroids.html
Controversies in the Use of Inhaled Steroid Treatment
for Allergic Rhinitis and Asthma 3/8/99
Excerpt:
"Lipworth recommended routine screening for potential systemic
toxicity in adults receiving long-term treatment with ICS in
doses above 800mgm/day of BDP or 200mgm/day of fluticasone.
Abnormal urinary cortisol levels (as described above) warrant
further searches for systemic toxicity (bone density, eye,
blood pressure and blood glucose measurements) as well as
sequential stadiometry growth measurements in children."
© Copyright 1997-1999 American Academy of Allergy, Asthma and Immunology
All rights reserved
Ellis
CBI
both or refer to one or both of the specialists.
--
Good Luck,
CBI, M.D.
powe...@msn.com
Mary wrote in message <3715EBEE...@ix.netcom.com>...
>I'm concerned about my husband's use of Pulmicort. He's been thrilled
>with it, because he can finally breathe easily (and I don't poke him in
>the night and tell him to use his inhaler). He uses 6-8 puffs of
>Pulmicort (1200-1600 mcg) daily along with Serevent twice a day (I think
>2 puffs each time). He reduces to 6 puffs of Pulmicort when he's feeling
>okay, but that usually doesn't last long before he's back to 8 puffs.
>
>So, it's treating the asthma just great! The problem is that he also has
>diabetes (he takes Glucatrol). His blood suger has been shooting up like
>you wouldn't believe! I'm sure it's from the Pulmicort. His blood suger
>is responding as it would to oral steroids.
>
>I keep telling him he needs to be referred to an endocrinologist and
>maybe a pulmonologist so they can work out the best combination for him
>-- treat his asthma AND keep his blood suger levels low. He's seeing a
>family doctor who doesn't seem too concerned about his high blood
>readings. I'm talking about going from a high of about 160 (2 hours
>after eating) to a high of 300!
>
>Mary
>
>
>LWyremba wrote:
>>
>> Normally a high dosis pulmicort (more than 800 - 1600 痢) Turbohaler has
Surfer!
>Mary wrote:
>>
>> I'm concerned about my husband's use of Pulmicort. He's been thrilled
>> with it, because he can finally breathe easily (and I don't poke him in
>> the night and tell him to use his inhaler). He uses 6-8 puffs of
>> Pulmicort (1200-1600 mcg) daily along with Serevent twice a day (I think
>> 2 puffs each time). He reduces to 6 puffs of Pulmicort when he's feeling
>> okay, but that usually doesn't last long before he's back to 8 puffs.
>Also make sure he uses the correct technique with the DPI.
>This involves breathing out first, then forcefully inhaling
>thru the Turbuhaler for as long as it takes, around 3 sec.
>in my case.
I then hold my breath for as long as I can (usually a count of 20) and
then breath out slowly. If I can't do this (because of illness or the
occasional cough) I can slightly taste the Pulmicort.
I also realised early on that standing up nice & straight & holding the
Turbohaler horizontal helped - previously I'd been treating it like
something full of liquid and holding it vertical whilst I bent over it.
<snip>
Surfer!
URL: http://www.nevis-vieww.demon.co.uk
Email: sur...@nevis-vieww.demon.co.uk
Hopeful anti-spam: alter double 'w' to single 'w' to view site & send Email.
adva...@my-dejanews.com
Thank you for your posting. I do take dialators also (serevent, maxair on
occasion). You have had your fair share of troubles. I take a little less
Pulmicort than you do. May I ask your approximate age? And have you had
asthma a very long time? I am 55 and am not always sure whether I am reading
very young asthma sufferers' mail -- aging (in my case) may have an effect.
In article <37127ae1....@news.direct.ca>,
cha...@NOSPAMdirect.ca. wrote:
> On Sun, 11 Apr 1999 17:52:59 GMT, adva...@my-dejanews.com wrote:
>
> >I use an inhaled steroid -- Pulmicort. I do not know if I am using a
medium
> >or high dose (total of six inhales daily at 200 mcg per dose). I am persuaded
> >that asthma damages airways in the long run without steroids. I do even
> >better on eight inhales (four twice daily). SHORT TERM SIDE EFFECTS: I don't
> >know if these are common effects. I get leg cramps. My feet seem painful
> >sometimes when I stand up for a long time. But cramps seem to run in my
> >family and lots of people have sore feet. It seems a lot worse -- could it be
> >Pulmicort? LONG TERM SIDE EFFECTS: these sound ominous, with diabetes,
> >glaucoma and cataracts, osteoporosis, heading the list. How common are these
> >in people who don't take oral steriods? How do you watch for them, or help
> >prevent them? Are any of you with longstanding use of steroids OLD and PRETTY
> >HEALTHY? I am getting old myself at 55 (asthma reactivated after years of not
> >having much). Thanks for you input, it's appreciated. DAVID
>
-----------== Posted via Deja News, The Discussion Network ==----------
Colleen Allen
>Dear Colleen:
> May I ask your approximate age? And have you had
>asthma a very long time? I am 55 and am not always sure whether I am reading
>very young asthma sufferers' mail -- aging (in my case) may have an effect.
Hi David,
I'm 58, and have suffered daily with uncontrollable severe asthma
for over 20 years --despite constant (daily) aggressive corticosteroid
treatment and the full complement of all the other standard asthma
medications.
I was diagnosed with severe persistent (adult onset) asthma at age 37
and moderate emphysema (via CTscan) last year. My asthma has been
chronically severe for nearly 21 years.
I had no previous history of asthma or lung problems before age 37
when I was admitted to the ICU ( in an emergency situation) due to
complications caused from a severe chest infection. Before that I
was in excellent health and I never even had a family doctor, and
never took any medication.
I had two young children ( under 12 year old) at that time; after
that first horrible episode in the ICU, my life changed totally. I
went from a very active mom, to a chronic invalid practically
over-night. And have been disabled ever since. However, my mind still
functions and I make good use of it. :) I am very thankful for my
computer and Internet connection which has allowed me to communicate
with the outside world again and to continue with my constant
research.
I was referred to a transplant unit for assessment for a single lung
transplant close to 6 years ago, however, after a great deal of
research into the long term survival rate of single lung transplants,
(which at that time averaged 12 months) I decided not to go ahead with
it.
My lung specialist is constantly urging me to have the transplant
while I am still able to. (the cut-off age here is 60 years of age),
however, I have made up my mind not to have any surgery.
Had I gone ahead and had it then, I wouldn't be here talking with you
today. I am still hoping for a medication break-through that will
control my asthma. That would make my life a lot easier.
My life is very difficult, however, I am still alive and still have
hope for control or a cure.
The CT scan last year (which diagnosed the emphysema) was done to
determine whether I would be eligable for LVRS (Lung volume reduction
surgery). I will not persue that surgery either.
Cheers,
Colleen
adva...@my-dejanews.com
After a miserable bronchial infection on top of a problem with GERD (reflux
disease) I started to cough. Except for those times when the medication is
working well, I have never stopped. That was two years ago.
My job's demands are not extremely physical so I still have that.
Good luck in finding improvement without draconian surgeries.
In article <371b9312....@news.direct.ca>,
-----------== Posted via Deja News, The Discussion Network ==----------