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The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

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Corticosteroids, inhaled (ICS)

5

XI.y Adrenal suppression

2
Last update : 22/04/2014
 
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Identify causative drugs
Diagnosing DIRD
1
Drug and radiation history
2
Drug singularity - Correct identification of the drug
3
Consistent timing of exposure v. onset of symptoms
4
Clinical, imaging, BAL, pathological pattern consistent with the specific drug
5
Careful exlusion of another cause
6
Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
8
Causality assessment
More detailed checklist
See also under
Beclomethasone
2
Budesonide (inhaled)
3
Corticosteroids, systemic (oral, parenteral)
5
Fluticasone (inhaled - ICS)
4

Publications

The use of inhaled corticosteroids and the risk of adrenal insufficiency.
The European respiratory journal 2013 Jul;42;79-86 2013 Jul
Reported adverse drug reactions during the use of inhaled steroids in children with asthma in the Netherlands.
European journal of clinical pharmacology 2006 May;62;343-6 2006 May
Decreased morning serum cortisol levels in children with asthma treated with inhaled fluticasone propionate.
Pediatrics 2002 Feb;109;217-21 2002 Feb
Effects of high-dose inhaled corticosteroids on plasma cortisol concentrations in healthy adults.
Archives of internal medicine 1999 Sep 13;159;1903-8 1999 Sep 13

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