It has taken us a long time to realize how the tobacco industry is creating a lot of public health concerns, from increasing the risk of lung cancer and the prevalence of COPD, to recognizing it as a risk factor in cardiovascular diseases. But while we now recognize vehemently the harm of smoking, do we realize, understand or appreciate all the benefits and harms of available smoking cessation products? Do we?
It seems the pendulum is always swinging back and forth with the management of COPD. Few years ago, we have pulled away from the use of high dose inhaled corticosteroids when we found its association with increased risk of pneumonia and related mortalities. Here’s my post on this topic. And thus, the treatment strategy has shifted to using more long acting bronchodilators. These bronchodilators include LABA (long acting beta agonist) and LAMA (long acting muscarinic antagonist).
Are you kidding me? We don’t have salbutamol nebules during the peak season where many people are experiencing shortness of breath due to pneumonia, respiratory infections or COPD/asthma exacerbation? Salbutamol is a quick acting bronchodilator medication which is often prescribed to relieve shortness of breath by opening up the airways to the lungs. It is an essential medicine.
Twenty years ago when I learned about COPD (chronic obstructive pulmonary disease) in pharmacy school, the focus was on smoking cessation. There were limited inhaler options back then; we only had salbutamol (Ventolin) and ipratropium (Atrovent) as metered dose inhalers. My impression at the time was that COPD should be prevented if at all possible because the treatment options were limited. Actually, I felt the inhalers were useless craps.
I am always reading something conflicting about steroids. They are good for you and they are also bad for you. The latest controversy is the role of inhaled corticosteroids in Chronic Obstructive Pulmonary Disease. Unlike asthma, the use of inhaled corticosteroids (ICS) has never demonstrated their clinical benefits consistently. They have been shown to improve symptoms, lung function and quality of life as well as reducing exacerbation in patients with FEV1 of less than 60% predicted. However, inhaled corticosteroids have not been demonstrated to prevent the progression of the disease nor to improve survival. Continue reading Inhaled Corticosteroids in COPD – To Abhor or to Adore?