Beware of Asthma Drugs

Although some of the frequently prescribed asthma drugs can be life-saving in an emergency, overuse or long-term use of most asthma medications can produce severe side effects. Oral corticosteroids, such as prednisone, may over a period of time increase a patient's risk for osteoporosis, diabetes, immune depression, adrenal suppression, cataracts, facial swelling, candidiasis, and a loss of minerals such as potassium, calcium, and magnesium, among other problems. Inhaled cortisone may also have serious side effects. In one study, taking inhaled corticosteroids in quantities of over 1.6 mg per day for three months significantly increased the risk of glaucoma or ocular hypertension in elderly patients.

There is also strong evidence that long-term use of inhaled corticosteroids can slow growth in asthmatic children, as cortisone drugs reduce collagen synthesis in children. This can occur with doses of beclomethasone at 400 micrograms (0.4 mg) or more daily, or budesonide at 800 micrograms (0.8 mg) or more daily. Fluticasone appears to be without adverse effects on growth when used in conventional doses but may have adverse effects when used in higher doses. It is not known at this time whether this growth suppression ultimately affects final adult height.

Inhaled cortisone can also suppress normal adrenal function and cause excessive weight gain; in clinical studies, 0.5 mg of fluticasone per day caused depleted cortisol levels and increased weight gain. Corticosteriods are also implicated in increased risk for osteoporosis or bone loss, since these drugs hamper absorption or magnesium and calcium, minerals necessary for strong bones.

Theophylline, which is related to chemicals found in coffee and chocolate and stimulates the heart and central nervous system can help a patient through a difficult period but can easily reach toxic levels, and is dangerous to anyone with a liver disorder. Additionally, it has been linked to the onset of learning disorders and nervousness.

Of even more concern today, however, may be studies showing an increased death rate from the use and misuse of the beta-agonist sprays. According to a 1992 report published in The New England Journal of Medicine, a pattern of increasing use over time is an important predictor of serious or fatal asthma attacks, as is doubling your monthly use, increasing your usage by one canister a month, or inhaling a total of more than one-and-a-half canisters per month. As to the latest symptom relievers for asthma (the anti-leukotriene, anti-IgE, anti-cytokine, and anti-platelet-activating products), further research is needed.



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