What is a common long-term adverse effect of inhaled corticosteroids, and how can it be minimized?

What is a common long-term adverse effect of inhaled corticosteroids, and how can it be minimized?

• A. Oral candidiasis; rinse mouth after use and use a spacer
• B. Hypertension; monitor blood pressure
• C. Osteoporosis; take calcium supplements
• D. Tremor; monitor weight

Answer: (A)

Inhaled corticosteroids commonly cause oral candidiasis because the medicine can pool in the mouth and throat, suppressing local defenses and allowing fungal overgrowth with long-term use. The best way to minimize this is to rinse the mouth and gargle with water after each inhalation, and use a spacer with the inhaler. The spacer reduces deposition of the drug in the oropharynx, delivering more to the lungs and less to oral tissues. Using the lowest effective dose and ensuring proper inhaler technique also help lessen this risk. While hypertension, osteoporosis, or tremor can be linked to systemic steroid exposure, they are less typical with standard inhaled therapy; thrush is the most common long-term local adverse effect and is specifically mitigated by mouth care and spacer use.

Inhaled corticosteroids commonly cause oral candidiasis because the medicine can pool in the mouth and throat, suppressing local defenses and allowing fungal overgrowth with long-term use. The best way to minimize this is to rinse the mouth and gargle with water after each inhalation, and use a spacer with the inhaler. The spacer reduces deposition of the drug in the oropharynx, delivering more to the lungs and less to oral tissues. Using the lowest effective dose and ensuring proper inhaler technique also help lessen this risk. While hypertension, osteoporosis, or tremor can be linked to systemic steroid exposure, they are less typical with standard inhaled therapy; thrush is the most common long-term local adverse effect and is specifically mitigated by mouth care and spacer use.