Inhaled corticosteroid dose comparison

Some older individuals will experience side effects that are more pronounced. Older adults have an increased risk of developing high blood pressure or osteoporosis (a disorder in which the bones lose mass and density) when taking corticosteroid drugs. Women, in particular, are at risk for this condition. However, recent research has suggested that the risk of non vertebral fracture in older adults is not higher in the short term when inhaled corticosteroid treatments are used.

Depending on the patient’s individual situation, older adults may be advised to undergo bone density screening, a test that can help detect osteoporosis. Patients at risk may also benefit from taking calcium supplements, undergoing hormone replacement therapy and exercising regularly.

Patients over the age of 50 also risk the development of cataracts (clouding of the lens of the eye) and glaucoma (a group of diseases that can damage the optic nerve, resulting in vision loss). For this reason, older adults taking high doses of corticosteroids may be advised to undergo eye examinations.

Lewis Sarett of Merck & Co. was the first to synthesize cortisone, using a 36-step process that started with deoxycholic acid, which was extracted from ox bile . [43] The low efficiency of converting deoxycholic acid into cortisone led to a cost of US $200 per gram. Russell Marker , at Syntex , discovered a much cheaper and more convenient starting material, diosgenin from wild Mexican yams . His conversion of diosgenin into progesterone by a four-step process now known as Marker degradation was an important step in mass production of all steroidal hormones, including cortisone and chemicals used in hormonal contraception . [44] In 1952, . Peterson and . Murray of Upjohn developed a process that used Rhizopus mold to oxidize progesterone into a compound that was readily converted to cortisone. [45] The ability to cheaply synthesize large quantities of cortisone from the diosgenin in yams resulted in a rapid drop in price to US $6 per gram, falling to $ per gram by 1980. Percy Julian's research also aided progress in the field. [46] The exact nature of cortisone's anti-inflammatory action remained a mystery for years after, however, until the leukocyte adhesion cascade and the role of phospholipase A2 in the production of prostaglandins and leukotrienes was fully understood in the early 1980s.

Inhaled glucocorticoids (also called inhaled corticosteroids or ICS) have fewer and less severe adverse effects than orally-administered glucocorticoids, and they are widely used to treat asthma and chronic obstructive pulmonary disease (COPD) [ 1 ]. However, there are concerns about the systemic effects of ICS, particularly as they are likely to be used over long periods of time, in infants, children, and older adults [ 2,3 ]. The safety of ICS has been extensively investigated since their introduction for the treatment of asthma 30 years ago [ 4-9 ].

Inhaled corticosteroid dose comparison

inhaled corticosteroid dose comparison


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