FCAAIA Notes: A little bad press can go a long way and can be hard to overcome even with a lot of good press. The long-acting beta agonists (long-acting cousins of albuterol, LABAs) are available with low dose inhaled in serval combination inhalers. LABAs were vilified about 10 years ago when a study showed they placed patients at risk of serious and even sometimes fatal asthma flares. However, that study (SMART study) looked at patients using salmeterol alone, without any inhaled steroids. In addition, patients requiring LABAs have more severe asthma to start with.
These two papers show that LABAs are extraordinarily safe when prescribed correctly. Continue reading “SERIOUS ASTHMA EVENTS WITH BUDESONIDE PLUS FORMOTEROL VS. BUDESONIDE ALONE and ARE LONG-ACTING BETA-AGONISTS SAFE TO ADD TO TREATMENT REGIMENS FOR ASTHMA IN CHILDREN?”
FCAAIA Notes: Inhaled corticosteroids (ICS) are the treatment of choice for persistent asthma as defined in every guideline or practice parameter EVER published (the first was published nearly 25 years ago). Over the years, numerous studies reported potential of side effects from this important class of mediation. But, none has actually shown the side effects to really be clinically relevant. Of course, since statistics cannot prove a negative thing, only studies with positive results get any attention.
As is pointed out in this study, the risks of poorly controlled asthma far out-weigh any potential risk of the medications used to treat it. Our guidelines and experience tell us other things not to be ignored. Continue reading “INHALED CORTICOSTEROIDS SAFE, EFFECTIVE, BUT SYSTEMIC COMPLICATION CONCERNS REMAIN”
FCAAIA Notes: No medication can give its best benefit if not taken properly. The same holds true for metered dose inhalers for asthma. If your inhaler does not help when you use it, maybe your technique is a little off.
Correct inhaler technique is difficult. There are a few small and simple steps like remembering to shake the inhaler before use. Other steps are harder. When the canister is depressed, the medication comes out at 60-80 mph. No wonder it is tough to coordinate the puff and the inhalation! As demonstrated in this article, errors are more than just common; they are practically the norm.
Do you need a review? Continue reading “APPROPRIATE USE OF PRESSURIZED METERED-DOSE INHALERS FOR ASTHMA”
FCAAIA Notes: The National Asthma Education and Prevention Program published its first set of guidelines for the diagnosis and management of asthma nearly 25 years ago. There have been several revisions since. However, all iterations of the Guidelines identify patients who should be treated with daily controller medications for asthma. Each iteration also stresses the importance of gradual steps down to the lowest controlling dose.
Importantly, no guideline published anywhere in the world states that patients should just STOP their controller medications without physician guidance. The reason is clear: Continue reading “PERCENTAGE OF PARTICIPANTS HAVE ASTHMA EXACERBATIONS UP TO 2 YEARS AFTER DECREASING CONTROLLER MEDICATIONS”