Potency of Inhaled Corticosteroids

Sunday, July 19, 2009, 12:23
Asthma
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Dr. Ayars, what about the potency of inhaled corticosteroids?
Dr. Ayars:: Well, that’s a great question and a very difficult one to answer, even for the experts, so I won’t even try to explain it here. There certainly is some differences in potency and some require much higher doses to get equivalent effects. And, in patients, one of the most important things is trying to get good compliance with their medications and admittedly, unless they’re very mild, I tend to use the newer, more potent ones with fewer puffs especially in my new patients so they don’t have to spend all day sucking on their inhaler. However, if patients are doing quite satisfactorily on the older ones that maybe are not quite as potent, and they are satisfied, I do not switch them.
Andrew:: Basically, if it’s working with the appropriate treatment, whatever the dosage is, you want them to just make it part of their life.
Dr. Ayars:: The most important thing is getting in the habit of using their preventative anti-inflammatory drug, such as the inhaled steroids, regularly, and if they are already in that habit, and they are doing fine, I would not switch them. But it is somewhat more convenient with the newer inhaled steroids to use them, because they often require fewer puffs.
Andrew:: Is it your experience that there are many people out there who had asthma for a while who just really haven’t yet gotten the message that there is this range of newer medications, more potent medications that really can improve their quality of life?
Dr. Ayars:: Absolutely and unfortunately, the message hasn’t gotten out to a lot of physicians. Some of them are still using the drugs we used 15 or 20 years ago, and just using bronchodilators and not appropriately using the anti-inflammatory drugs that they should be using in patients that have at least significant mild to moderate asthma. And especially for severe asthma, they definitely should be on preventative drugs, including the inhaled steroids.

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