These sprays or inhaled powders are cortisone-like medicines that are inhaled directly into the lungs. They act as anti-inflammatory drugs and help reduce bronchial sensitivity over a period of time. If asthma is present, these medications should be taken after using a bronchodilator. The most commonly used topical steroids are Aldecin, Becloforte, Becotide and Pulmicort.
Pulmicort (budesonide) has just been released on the Australian market. It is taken through a metered dose inhaler called a Turbuhaler, which is breath activated and contains no chlorofluorocarbons (CFCs), fillers or additives. The Turbuhaler is preloaded with 200 doses of pure medication, and it contains an indicator to warn users when they have reached the last 20 doses.
Recently there have been concerns among doctors worldwide that beta-agonists, such as Ventolin, are being used too often by some patients, particularly chronic asthmatics. There is a current trend among many doctors to change their prescribing patterns by recommending that patients on regular doses of beta-agonists should switch to preventive therapy with topical steroids. The steroids repress the bronchial inflammation and sensitivity of the lungs as well as relieve symptoms. Under this medication regime, beta-agonists would be used to relieve any attacks that break through.
Topical steroids do not bring instant relief and can take one to four weeks to become effective. While waiting for preventive medicines to take effect, patients should continue with metered doses of bronchodilators. The bronchodilatots can be reduced once maximum lung function is reached. Doctors report that patients should be able to significantly reduce their use of bronchodilators and still maintain good lung function after using preventive medicines over a period of time.
SIDE EFFECTS OF INHALED STEROIDS
The side effects from inhaled steroids are minimal. Even in high doses, they do not have the side effects associated with steroid tablets. This is because the dose is so small that the drug acts only on the lungs and is not absorbed into the body. Some people experience a slightly hoarse voice or sore throat after use. Others develop a fungal infection in the throat or mouth, but such a condition generally responds quickly to treatment. The patient’s mouth should be rinsed out immediately after each dose is administered to prevent these side effects. Inhaled steroids should be used with a spacer, such as a Nebuhaler or Volumatic.
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For people who cannot take flu vaccine or who failed to get vaccine protection in time and face a high risk of serious complications from the flu, there are two antiviral drugs—amantadine hydrochloride (Symmetrel) and rimantidine hydrochloride (Flumadine)— that can help to prevent infection by the type A flu virus, the most deadly one. These drugs are also helpful for people who took the vaccine but need extra protection, such as elderly people with heart or lung disease.
The drugs prevent type A flu viruses (but not type В viruses) from multiplying in the body. They are about 75 to 80 percent effective in preventing type A influenza, the type of flu that results in the most serious complications. However, to be effective, they must be taken daily before a flu outbreak begins and throughout the entire flu season since, unlike the vaccine, they have no lasting effect. In addition to their preventive value, the drugs may help shorten the course of an attack of type A influenza among people who should have been vaccinated but weren’t.
The drugs have some side effects that unfortunately are more frequent in people over sixty-five, the group most in need of protection. Typical side effects involve the central nervous system: difficulty sleeping, tremulousness, depression or confusion. However, these effects are usually mild and often go away while the medication is still being taken.
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The brucella germs are the cause of brucellosis or undulant fever. Undulant fever has been known also as Malta fever. The condition is far more widespread now than formerly, although methods of prevention have been developed based on our knowledge of the fact that the disease is spread through drinking milk from infected cattle and through contact with the meat of infected animals.
Aureomycin has been found to produce prompt improvement in the symptoms of undulant fever with a lowering of the fever, a reduction in the size of the spleen and the other general symptoms of this disease which are so unpleasant. Streptomycin and sulfadiazine employed together are especially effective in controlling the organisms of undulant fever. Aureomycin seems to be preferred, however, to this combination of drugs because later reports show more satisfactory results and less of the toxic reactions that accompany the use of the other antibiotics. The results with terramycin appear to be about as good as those with aureomycin.
Before the antibiotic drugs were discovered and found to be so useful in brucellosis, patients were usually put to bed and given proper diet. Under these circumstances they seemed to recover gradually, although relapses were exceedingly frequent. Brucellosis is a rather chronic disease which may last for several months – even years – and be quite weakening. After the infection is over, people are weak, fatigued, nervous and often depressed. Loss of ambition is one of the most prominent symptoms of people who have had undulant fever.
Because the emotional reaction to the weakness may be so great, doctors are warranted in assuring patients that with proper treatment, complete recovery may occur and they can eventually regain their strength. In order to enable the person who has been weakened by a chronic disease to regain strength, rest, sunshine and a good diet with plenty of protein and vitamins is of the utmost importance.
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