Medical Health Encyclopedia

The widespread use of inhaled corticosteroids for COLD patients is under debate, particularly since other agents are equally or more effective. Studies are mixed on whether long-term use improves lung function. They also can have some significant adverse effects over time, particularly in reducing bone density. Combination inhalers that contain both a corticosteroid and a long-acting beta 2 agonist may prove to be a good option.

Common side effects of inhaled steroids are throat irritation, hoarseness, and dry mouth. Other possible but less common adverse effects include rashes, wheezing, facial swelling (edema), fungal infections (thrush) in the mouth and throat, and bruising.

Inhaled steroids are generally considered safe and effective. They rarely cause any of the more serious side effects reported with prolonged use of oral steroids. There are some risks with long term use however, A 2001 study, however, reported a higher risk for cataracts in patients over age 40. Others are reporting a higher risk for bone loss in patients who take inhaled steroids regularly. (A number of bone-preserving medications are now available that might safely offset this effect.) There is also some concern that the more potent agents, particularly fluticasone, may suppress the adrenal system (which secretes natural steroids) to a greater degree than other steroid inhalants. (This is a serious side effect of oral steroids.)

Antibiotics

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Treating Acute Bronchitis or Pneumonia in COLD Patients. People with COLD are at heightened risk for pneumonia, but any lung infection can worsen symptoms and is dangerous in COLD patients. Aggressive therapy using powerful antibiotics is usually called for when acute bronchitis or pneumonia occurs. The most common organisms causing pneumonia in chronic obstructive lung disease patients include Streptococcus pneumoniae, Chlamydia pneumoniae, Haemophilus influenzae, and Legionella pneumophila. Of some concern is the increase in more unusual and difficult-to-treat organisms known as gram-negative bacteria.