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Short-course oral corticosteroids when required in severely uncontrolled asthma; Step 5: Further worsening of symptoms and increased occurrence of exacerbations . Add-on long-acting muscarinic antagonists; Refer for phenotypic assessment with or without biologic therapy; Consider high dose inhaled corticosteroids and formoterol maintenance therapy
Fluticasone propionate, sold under the brand names Flovent and Flonase among others, is a glucocorticoid steroid medication. [8] When inhaled it is used for the long term management of asthma and COPD. [8] In the nose it is used for hay fever and nasal polyps. [9] [10] It can also be used for mouth ulcers. [11] It works by decreasing inflammation.
While the use of inhaled steroids and long-acting beta2‑adrenergic agonists are recommended for the resulting improvement in control of symptoms of asthma, [10] concerns have been raised that salmeterol may increase the risk of death due to asthma, and this additional risk is not reduced by the addition of inhaled steroids. [11]
The inhaled form is generally safe in pregnancy. [16] Budesonide chiefly acts as a glucocorticoid. [16] Budesonide was initially patented in 1973. [17] Commercial use as an asthma medication began in 1981. [18] It is on the World Health Organization's List of Essential Medicines. [19] Some forms are available as a generic medication.
[17] [18] It has been shown to, 1) reduce asthma exacerbations that require oral corticosteroids, 2) reduce hospital visits better than maintenance on inhaled corticosteroids alone at a higher dose, or 3) inhaled corticosteroid at the same or higher dose together with a long-acting bronchodilator (LABA), with a short-acting bronchodilator (SABA ...
Furthermore, drugs used to treat asthma (such as inhaled glucocorticoids or leukotriene receptor antagonists) also reduce eNO levels. Clinical trials have looked at whether tailoring asthma therapy based on eNO values is better than conventional care, in which therapy is gauged by symptoms and the results of lung function tests.
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