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Resumen
Los corticoides inhalados (CI) se utilizan en la enfermedad pulmonar obstructiva crónica (EPOC) porque disminuyen la frecuencia de exacerbaciones y frenan la caída de la calidad de vida relacionada con la salud. Los mecanismos íntimos que fundamentan su utilización no están suficientemente establecidos. Tampoco está definida la dosis en que deben administrarse. Los CI tienen efectos secundarios que apenas son esbozados en las guías de manejo de la enfermedad y en ocasiones ni se mencionan. Los CI se han relacionado con efectos secundarios en las vías aéreas altas, la hipertensión intraocular y el glaucoma, la pérdida de masa ósea y las fracturas, la supresión suprarrenal y últimamente con la neumonía. En algunos de estos procesos el debate sobre su protagonismo sigue abierto. Sea como fuere, dada la frecuencia creciente en el uso de estos fármacos es obligado conocer sus potenciales efectos secundarios, máxime cuando las características farmacodinámicas de los distintos CI son muy diferentes.
Palabras clave:
Corticoides inhalados
Enfermedad pulmonar obstructiva crónica
Efectos adversos locales y sistémicos
Abstract
Inhaled corticosteroids (IC) are used in chronic obstructive pulmonary disease (COPD) as these agents decrease the frequency of exacerbations and halt the impairment in health-related quality of life. The intimate mechanisms supporting their use and the dose that should be employed have not been sufficiently well established. IC have adverse effects that are hardly described in guidelines for the management of COPD and are sometimes not even mentioned. These agents have been related to adverse effects in the upper airways, intraocular hypertension and glaucoma, loss of bone mass and fractures, adrenal suppression and, lately, with pneumonia. The debate on the role of CI in these processes is ongoing. However, given the growing frequency of the use of these drugs, awareness of their potential adverse effects is essential, especially since the pharmacodynamic characteristics of the distinct IC differ widely.
Keywords:
Inhaled corticosteroids
Chronic obstructive pulmonary disease
Local and systemic adverse effects
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