For many patients with COPD, inhalation medicine is essential, and some inhalation medicines contain hormones. This has also caused confusion for many patients with COPD. There are many people with COPD in the "Looking on Respiratory" group who have COPD who want to learn about inhaling hormones. Why inhaling hormones? Will there be any side effects? Can it be used for a long time? With a series of questions, the editor interviewed Guo Yanfei, director of the Department of Respiratory and Critical Care at Beijing Hospital, . " anti-inflammatory " of
hormone is not anti-infection
Director Guo emphasized that from a large classification, hormones are divided into glucocorticoid and mineralocorticoid . Glucocorticoids are generally used to treat chronic airway inflammation diseases such as COPD. Glucocorticoids mainly have anti-inflammatory effects, but the anti-inflammatory mentioned here is different from the anti-inflammatory that we usually take "anti-inflammatory drugs".
What we commonly call anti-inflammatory drugs are actually anti-infective drugs, including bacterial infections and viral infections, which are caused by pathogenic microorganism . Inflammation of glucocorticoids, including neutrophils, macrophages, eosinophils, , etc., are two concepts with infection.
hormone effect is obvious, but not everyone should use
Director Guo said that many research results show that these therapeutic drugs containing hormones can significantly reduce the number of acute aggravation and mortality in patients. However, not all patients need to use hormones. For patients in the stable stage, the use of bronchodilator is considered based on the patient's symptoms and clinical characteristics, the risk of acute exacerbation, the value of hematocrit and comorbidities and complications. Generally speaking, only patients with severe symptoms will prescribe hormone-containing drugs to patients.
Take triple drugs as an example. Generally, patients who belong to group D in the lung disease classification (characteristics are high risks and many symptoms; lung function classification is GOLD3-4; acute exacerbations in the previous year are ≥2; mMRC classification is ≥2), or peripheral blood eosinophils are greater than 100/uL. Of course, this requires the doctor to analyze according to the different situations of each patient.
hormone-containing drugs also need to be used for a long time
COPD is a chronic disease. Regardless of whether the drug contains hormones or not, you cannot stop taking the drug at will, otherwise it will easily lead to the patient's symptoms worsening sharply in a short period of time. But it may not be that you stop the medication today and you will get severe wheezing tomorrow. However, this symptom must be accompanied by the extension of the medication time and gradually worsens, mainly the aggravation of cough, sputum or shortness of breath, and chest tightness.
When the symptoms reach a certain level and the patient is taken seriously, a new round of treatment may be initiated after the doctor evaluates. Director Guo particularly emphasized that it will take a long time for the patient to return to the state before the drug is stopped. This time may be measured weekly or monthly.
hormone-containing drugs have few side effects, and if the method is not correct, it will cause "side effects"
The side effects of hormone-containing drugs are also something that many patients are worried about. However, for patients with COPD, when doctors prescribe a therapeutic drug, they must make the greatest trade-offs and considerations in terms of the efficacy and safety of the drug. We hope to prescribe the patients with the best results and the least adverse reactions.
Inhaled medicine for COPD is directly entered into the lungs from the respiratory tract. We call the "deposition rate", the better, and it plays a positive role. Inhaling hormone-containing drugs is not completely without side effects, because some drug components will inevitably be deposited in our pharynx during inhalation. If you don’t rinse your mouth properly, some patients will feel hoarse and dry and painful in the pharynx over time.
There are some serious side effects of the candida concentration in the oropharynx, that is, a specific type of microorganism "stays" there, causing some local fungal infections. The main manifestation is that the phlegm is sticky, and sometimes the phlegm is "drawn" and it will be very laborious to cough out the phlegm.But whether it is Candida colonization still needs to go to the hospital for examination to know.
In the patient group of "Looking at Respiratory" a friend raised concerns about osteoporosis . Director Guo also explained this issue. Since inhaled glucocorticoids only act on the local level, the probability of systemic adverse reactions including osteoporosis is very low, so it should be relatively safe.
*This content is a medical popular science and is for reference only and cannot be used as a basis for diagnosis and medical treatment #Health Science Popular Science Competition#
