Practical considerations for dysphonia caused by inhaled corticosteroids.
Practical considerations for dysphonia caused by inhaled corticosteroids.
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DOI：
10.1016/j.mayocp.2012.06.022
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发表时间：
2012-09
影响因子：
8.9
通讯作者：
C. Galván;J. Guarderas
中科院分区：
文献类型：
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作者：
C. Galván;J. Guarderas
吸入皮质类固醇（ICS）治疗已成为治疗哮喘的标准方法。ICS治疗常见的局部不良反应是语音障碍，据报道影响5%至58%的患者。虽然与ICS治疗相关的发声障碍的原因尚未得到充分研究，但它可能是由于在给药过程中活性ICS在口咽部沉积，从而导致喉咽部肌病或粘膜作用。在评估语音障碍时应考虑使用ICS。我们建议使用最低有效剂量的ICS，用间隔剂给药，漱口，吸入后漱口和洗脸，并清洗间隔剂。如果在这些干预措施后仍出现发声障碍，则应暂停使用ICS，直到症状消退，前提是哮喘控制不受影响。
Inhaled corticosteroid (ICS) therapy has become standard in the treatment of asthma. A common local adverse effect of ICS therapy is dysphonia, which has been reported to affect 5% to 58% of patients. Although causes of dysphonia associated with ICS therapy have been underinvestigated, it may result from deposition of an active ICS in the oropharynx during administration, which then causes myopathy or a mucosal effect in the laryngopharynx. Use of ICS should be considered during any evaluation of dysphonia. We recommend using the lowest effective dosage of ICS, administering medication with a spacer, gargling, rinsing the mouth and washing the face after inhalation, and washing the spacer. If dysphonia develops despite these interventions, ICS use should be suspended until symptoms resolve, provided that asthma control is not compromised.