How is use of glucocorticoids in asthma management?

Improve symptoms and LF, decrease BHR, and mortality. oral, PRL or inhaled. oral prednisone used for acute exacerbation unresponsive for bronchodilators Safe and effective for moderate-severe cases used for years ICS (inhaled corticosteroids) Beclomethasone, triamcinolone, fluticasone, budesonide, mometasone... (ICS) impaired effect for smokers, and long term use is good safety profile Recommended low dose in asthma symptoms (more than twice a week), waking due to asthma more than once in a month and any asthma symptom + any risk factor for exacerbation) We should make sure right dx, symptom monitored, LFT, train pt to use drug, and follow up High dose can cause Hypophyseal adrenal axis supression, local effects (horseness, dysphonia, cough and candidiasis)