ABSTRACT
OBJECTIVE: To describe and characterize local adverse effects (in the oral cavity, pharynx, and larynx) associated with the use of inhaled corticosteroids (ICSs) in patients with moderate or severe asthma. METHODS: This was a cross-sectional study involving a convenience sample of 200 asthma patients followed in the Department of Pharmaceutical Care of the Bahia State Asthma and Allergic Rhinitis Control Program Referral Center, located in the city of Salvador, Brazil. The patients were ≥ 18 years of age and had been using ICSs regularly for at least 6 months. Local adverse effects (irritation, pain, dry throat, throat clearing, hoarseness, reduced vocal intensity, loss of voice, sensation of thirst, cough during ICS use, altered sense of taste, and presence of oral candidiasis) were assessed using a 30-day recall questionnaire. RESULTS: Of the 200 patients studied, 159 (79.5%) were women. The mean age was 50.7 ± 14.4 years. In this sample, 55 patients (27.5%) were using high doses of ICS, with a median treatment duration of 38 months. Regarding the symptoms, 163 patients (81.5%) reported at least one adverse effect, and 131 (65.5%) had a daily perception of at least one symptom. Vocal and pharyngeal symptoms were identified in 57 (28.5%) and 154 (77.0%) of the patients, respectively. The most commonly reported adverse effects were dry throat, throat clearing, sensation of thirst, and hoarseness. CONCLUSIONS: Self-reported adverse effects ...
OBJETIVO: Descrever e caracterizar os eventos adversos locais na orofaringe e laringe associados ao uso de corticosteroide inalatório (CI) em pacientes com asma moderada ou grave. MÉTODOS: Estudo de corte transversal, com amostra de conveniência composta por 200 pacientes acompanhados no Serviço de Assistência Farmacêutica da Central de Referência do Programa para Controle da Asma na Bahia, em Salvador (BA). Os pacientes tinham ≥ 18 anos e estavam em uso regular de CI por período ≥ 6 meses. Os eventos adversos locais (irritação, dor, garganta seca, pigarro, rouquidão, redução da potência da voz, perda de voz; sensação de sede, tosse durante inalação, alteração do paladar e presença de monilíase oral) foram avaliados por meio de um questionário com período recordatório de 30 dias. RESULTADOS: Dos 200 pacientes estudados, 159 (79,5%) eram mulheres. A média de idade foi de 50,7 ± 14,4 anos. Nesta amostra, 55 pacientes (27,5%) utilizavam altas doses de CI, com mediana de duração de tratamento de 38 meses. Em relação aos sintomas, 163 pacientes (81,5%) reportaram ao menos um evento adverso, e 131 (65,5%) tinham a percepção diária de pelo menos um sintoma. Os sintomas de voz e de faringe foram identificados em 57 (28,5%) e 154 (77,0%) pacientes, respectivamente. Os eventos adversos mais frequentemente relatados foram garganta seca, ...
Subject(s)
Female , Humans , Male , Middle Aged , Anti-Asthmatic Agents/adverse effects , Asthma/drug therapy , Beclomethasone/adverse effects , Budesonide/adverse effects , Glucocorticoids/adverse effects , Oropharynx/drug effects , Administration, Inhalation , Anti-Asthmatic Agents/administration & dosage , Beclomethasone/administration & dosage , Budesonide/administration & dosage , Cross-Sectional Studies , Glucocorticoids/administration & dosage , Hoarseness/chemically induced , Severity of Illness Index , ThirstABSTRACT
Mucositis is a disturbing side effect of radiotherapy treatment for head and neck cancer. To date, no effective modality for its prophylaxis and treatment has been found. We performed this study to evaluate the efficacy of oral zinc sulphate in delaying the onset of oral and pharyngeal mucositis and decreasing their severity. A total of 58 patients who were treated for head and neck squamous cell carcinoma with radiotherapy or chemoradiotherapy were randomly assigned to receive oral zinc sulphate [220 mg] or an oral placebo 3 times a day during their radiotherapy course. Total radiation dose was 6000 cGy to 7000 cGy by conventional radiotherapy. Seventy nine percent of the patients also received concurrent chemotherapy. Oral and pharyngeal mucositis were scored according to an RTOG protocol. Time to onset of mucositis did not vary between the two groups. However, oral mucositis scores were less severe in the zinc group in weeks 4 to 6. The difference was statistically significant and the P values for weeks 4, 5 and 6 were 0.02, 0.007, and 0.012, respectively. Treatment interruptions in both groups were the same [four cases each] and all were due to dysphagia [pharyngeal mucositis]. Our results suggest that zinc is effective in reducing the severity of oral mucositis but not pharyngeal mucositis. Treatment interruptions were more frequently caused by pharyngeal mucositis which presented as dysphagia, rather than oral pain that was a manifestation of oral mucositis