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When combined with inhaled steroids, β adrenoceptor agonists can improve symptoms. [1] [2] In children this benefit is uncertain and they may be potentially harmful. [2]They should not be used without an accompanying steroid due to an increased risk of severe symptoms, including exacerbation in both children and adults. [3]
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]
If high doses were used for six to 10 days, reduce to replacement dose immediately and taper over four more days. Adrenal recovery can be assumed to occur within two to four weeks of completion of steroids. If high doses were used for 11–30 days, cut immediately to twice replacement, and then by 25% every four days.
While the evidence for corticosteroids causing peptic ulceration is relatively poor except for high doses taken for over a month, [32] the majority of doctors as of 2010 still believe this is the case, and would consider protective prophylactic measures. [33] Eyes: chronic use may predispose to cataract and glaucoma.
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.
Guidelines on the choice of agents and how best to step up treatment for various subgroups in hypertension (high blood pressure) have changed over time and differ between countries. A Comparison of International Guidelines on Goal Blood Pressure and Initial Therapy for Adults With Hypertension (adapted from JNC 8 guidelines [ 1 ] )