Respiratory: Airways disease, use of corticosteroids

Question 1

An ICS used for 3-4 weeks can help to differentiate between asthma and copd how?

Answer 1

Asthma will have a clear improvement.

Question 2

An ICS is used regularly for the prophylaxis of asthma when patients require beta2 agonist how often?

Answer 2

More than twice a week or if symptoms disturb sleep at least once a week, or if the patient has suffered an exacerbation in the last 2 years requiring a systemic corticosteroid.

Question 3

Corticosteroid inhlaers must be used regularly for maximum benefit; alleviation of symptoms usually occurs how long after initiation?

Answer 3

3 to 7 days.

Question 4

In adults using an inhaled corticosteroid and a long-acting beta2 agonist for the prophylaxis of asthma, but who are poorly controlled, Symbicort® or DuoResp Spiromax can be used as relievers in addition to their regular use for the prophylaxis of asthma. What do they both contain?

Answer 4

Budesonide with formeterol.

Question 5

Symbicort® can also be used in this way in adults using an inhaled corticosteroid with a dose greater than beclometasone dipropionate ___ micrograms daily, but who are poorly controlled (standard doses of other inhaled corticosteroids can be used).

Answer 5

Symbicort® can also be used in this way in adults using an inhaled corticosteroid with a dose greater than beclometasone dipropionate 400 micrograms daily, but who are poorly controlled (standard doses of other inhaled corticosteroids can be used).

Question 6

Patients using budesonide with formoterol as a reliever ______ or more should have their treatment reviewed regularly. The use of Symbicort® for both reliever and maintenance therapy is also used by some specialists in children 12–18 years [unlicensed].

Answer 6

Patients using budesonide with formoterol as a reliever once a day or more should have their treatment reviewed regularly. The use of Symbicort® for both reliever and maintenance therapy is also used by some specialists in children 12–18 years [unlicensed].

Fostair® can also be used in adults as a reliever (instead of a short-acting beta2 agonist) in addition to its regular use for the prophylaxis of asthma.

Question 7

In chronic asthma, when the response to other drugs has been inadequate, longer term administration of an oral corticosteroid may be necessary; in such cases what should happen to any doses of ICS?

Answer 7

In chronic asthma, when the response to other drugs has been inadequate, longer term administration of an oral corticosteroid may be necessary; in such cases high doses of an inhaled corticosteroid should be continued to minimise oral corticosteroid requirements.

Question 8

An acute attack of asthma should be treated with a short course of an oral corticosteroid starting with a high dose.

The dose can usually be stopped abruptly; tapering is not needed provided that the patient receives what?

Answer 8

The dose can usually be stopped abruptly; tapering is not needed provided that the patient receives an inhaled corticosteroid in an adequate dose

Question 9

An oral corticosteroid should normally be taken as a single dose when and why?

Answer 9

An oral corticosteroid should normally be taken as a single dose in the morning to reduce the disturbance to circadian cortisol secretion

Question 10

In COPD, inhaled corticosteroid therapy has what benefit?

Answer 10

may reduce exacerbations when given in combination with an inhaled long-acting beta2 agonist