Inhaled drugs for asthma
...rt-term effects on tibial growth when the maximum recommended dose is used have been reported with several preparations. These are counterbalanced by other studies that find no significant reduction in long-term growth. Several authorities have proposed that, catch up growth occurs eventually. Patients at high risk for osteoporosis such as post-menopausal women are the other major concern. Some bone density studies show loss of mineral whereas others do not. As any side effect depends on dose, the dose required for the desired therapeutic effect must be related to the dose that causes side effects. Claims of a better risk/benefit ratio for one preparation as opposed to another are not easily evaluated because neither the benefit nor the risk is easily measured. A considerable portion of the inhaled dose deposits in the mouth and pharynx where it can not only be swallowed for systemic absorption but also reduce mucosal resistance to yeast infections. Some patients develop oral Candidiasis (Moniliasis, thrush) with characteristic white plaques on the mucosa. Some also experience hoarseness. To prevent this problem, immediately after inhalation, patients should rinse the mouth with water and spit it out. If the infection occurs anyway it can be treated with oral gargles with mycostatin (Nystatin®). With Freon propelled preparations, a "spacer" will improve therapeutic effect and minimize oral deposition and thus reduce the risk of local or systemic side effects. These are separately prescribed chambers that are attached to the aerosol devi...