title: Local side-effects during 4-year treatment with inhaled corticosteroids--a comparison between pressurized metered-dose inhalers and Turbuhaler.
abstract: Local side-effects, such as hoarseness and oropharyngeal candidiasis, are often seen during treatment of patients with inhaled corticosteroids (ICS). We investigated whether changing from pressurized metered-dose inhalers (pMDI) to Turbuhaler influenced the type and frequency of local side-effects. Local side-effects were recorded for a 2-year period in which 154 patients used ICS pMDI with a spacer device. They were followed for an equally long period of time (26.2 +/- 5.7 months) while using Turbuhaler, as were 90 patients who received Turbuhaler as their first ICS preparation. After inhalation, all patients rinsed out their mouths with water. In experienced pMDI-users, the frequency of local side-effects decreased from 21% to 6%. The reduction was due to a lower incidence of hoarseness. Candidiasis or hoarseness was not seen in patients given Turbuhaler as their first ICS device. Our fear of an increased incidence of local side-effects when giving ICS in Turbuhaler was unwarranted.
authors.affiliation: Mjölbolsta Hospital, Karis, Finland.
authors.forename: O
authors.initials: O
authors.lastname: Selroos
authors.forename: R
authors.initials: R
authors.lastname: Backman
authors.forename: K O
authors.initials: KO
authors.lastname: Forsén
authors.forename: A B
authors.initials: AB
authors.lastname: Löfroos
authors.forename: M
authors.initials: M
authors.lastname: Niemistö
authors.forename: A
authors.initials: A
authors.lastname: Pietinalho
authors.forename: C
authors.initials: C
authors.lastname: Aikäs
authors.forename: H
authors.initials: H
authors.lastname: Riska
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000188:drug therapy; D002177:Candidiasis / Q000139:chemically induced; D005260:Female; D006685:Hoarseness / Q000139:chemically induced; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D011208:Powders; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones; D011208:Powders