Tapering inhaled corticosteroids

The growth of children and adolescents receiving orally inhaled corticosteroids, including QVAR, should be monitored routinely (., via stadiometry). If a child or adolescent on any corticosteroid appears to have growth suppression, the possibility that he/she is particularly sensitive to this effect should be considered. The potential growth effects of prolonged treatment should be weighed against clinical benefits obtained and the risks associated with alternative therapies. To minimize the systemic effects of orally inhaled corticosteroids, including QVAR, each patient should be titrated to his/her lowest effective dose [see Dosage and Administration ( )] .

Patients requiring oral corticosteroids should be weaned slowly from systemic corticosteroid use after transferring to PULMICORT RESPULES (budesonide inhalation suspension) . Initially, PULMICORT RESPULES should be used concurrently with the patient's usual maintenance dose of systemic corticosteroid. After approximately one week, gradual withdrawal of the systemic corticosteroid may be initiated by reducing the daily or alternate daily dose. Further incremental reductions may be made after an interval of one or two weeks, depending on the response of the patient. Generally, these decrements should not exceed 25% of the prednisone dose or its equivalent. A slow rate of withdrawal is strongly recommended.

In another randomized, placebo-controlled, parallel-group trial (n=642) in a similar population of adult patients previously maintained, but not adequately controlled, on inhaled corticosteroids (beclomethasone 336 mcg/day), the addition of SINGULAIR to beclomethasone resulted in statistically significant improvements in FEV 1 compared with those patients who were continued on beclomethasone alone or those patients who were withdrawn from beclomethasone and treated with montelukast or placebo alone over the last 10 weeks of the 16-week, blinded treatment period. Patients who were randomized to treatment arms containing beclomethasone had statistically significantly better asthma control than those patients randomized to SINGULAIR alone or placebo alone as indicated by FEV 1 , daytime asthma symptoms, PEFR, nocturnal awakenings due to asthma, and “as-needed” β-agonist requirements.

For 6 months I searched for my dream dressage horse. I was in my 50s and wanted a horse that was well trained and fun to ride. This was to be my last horse purchase so the age had to be around 10 so we could grow old together". A broker called me and said she found the perfect horse for me. I made arrangements to go down to Wellington on Monday to try him.

Rubinski was truly a dream horse. He had been shown at the Intermediate Level and scored well. He was 10 years old and fun to ride. He was handsome and sweet. The owner made a call to a veterinarian at Palm Beach Equine He would be vetted on Thursday. The arrangements happened quickly because supposedly the horses were to ship up north on Friday, so I had to make a decision right away. I knew better than to do that but I was in love and blind to anything but having Rubinski come home with me.

Tapering inhaled corticosteroids

tapering inhaled corticosteroids

For 6 months I searched for my dream dressage horse. I was in my 50s and wanted a horse that was well trained and fun to ride. This was to be my last horse purchase so the age had to be around 10 so we could grow old together". A broker called me and said she found the perfect horse for me. I made arrangements to go down to Wellington on Monday to try him.

Rubinski was truly a dream horse. He had been shown at the Intermediate Level and scored well. He was 10 years old and fun to ride. He was handsome and sweet. The owner made a call to a veterinarian at Palm Beach Equine He would be vetted on Thursday. The arrangements happened quickly because supposedly the horses were to ship up north on Friday, so I had to make a decision right away. I knew better than to do that but I was in love and blind to anything but having Rubinski come home with me.

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