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AIRDUO DIGIHALER (fluticasone propionate and salmeterol)inhalation powder(八)
2019-07-16 23:44:05 来源: 作者: 【 】 浏览:18907次 评论:0
pletely withdrawn. During this period of HPA suppression, patients may exhibit signsand symptoms of adrenal insufficiency when exposed to trauma, surgery, or infection(particularly gastroenteritis) or other conditions associated with severe electrolyte loss. AlthoughAirDuo Digihaler may improve control of asthma symptoms during these episodes, inrecommended doses it supplies less than normal physiological amounts of corticosteroidsystemically and does NOT provide the mineralocorticoid activity that is necessary for copingwith these emergencies.
During periods of stress or a severe asthmatic attack, patients who have been withdrawn fromsystemic corticosteroids should be instructed to resume oral corticosteroids (in large doses)immediately and to contact their physician for further instruction. These patients should also beinstructed to carry a medical identification warning card indicating that they may needsupplementary systemic corticosteroids during periods of stress or a severe asthma attack.
Patients requiring systemic corticosteroids should be weaned slowly from systemic corticosteroiduse after transferring to AirDuo Digihaler. Lung function (mean forced expiratory volume in1 second [FEV1] or morning peak expiratory flow [AM PEF]), beta-agonist use, and asthmasymptoms should be carefully monitored during withdrawal of systemic corticosteroids. Inaddition to monitoring asthma signs and symptoms, patients should be observed for signs andsymptoms of adrenal insufficiency, such as fatigue, lassitude, weakness, nausea and vomiting,and hypotension.
Transfer of patients from systemic corticosteroid therapy to AirDuo Digihaler may unmaskallergic conditions previously suppressed by the systemic corticosteroid therapy (e.g., rhinitis,conjunctivitis, eczema, arthritis, eosinophilic conditions).
During withdrawal from oral corticosteroids, some patients may experience symptoms ofsystemically active corticosteroid withdrawal (e.g., joint and/or muscular pain, lassitude,depression) despite maintenance or even improvement of respiratory function.
5.7 Hypercorticism and Adrenal Suppression
Fluticasone propionate, a component of AirDuo Digihaler, will often help control asthmasymptoms with less suppression of HPA function than therapeutically equivalent oral doses ofprednisone. Since fluticasone propionate is absorbed into the circulation and can be systemicallyactive at higher doses, the beneficial effects of AirDuo Digihaler in minimizing HPA dysfunctionmay be expected only when recommended dosages are not exceeded and individual patients aretitrated to the lowest effective dose. A relationship between plasma levels of fluticasonepropionate and inhibitory effects on stimulated cortisol production has been shown after 4 weeks
of treatment with fluticasone propionate inhalation aerosol. Since individual sensitivity to effectson cortisol production exists, physicians should consider this information when prescribingAirDuo Digihaler.
Because of the possibility of significant systemic absorption of inhaled corticosteroids, patientstreated with AirDuo Digihaler should be observed carefully for any evidence of systemic corticosteroid effects. Particular care should be taken in observing patients postoperatively orduring periods of stress for evidence of inadequate adrenal response.
It is possible that systemic corticosteroid effects such as hypercortic
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