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Thorax 2000;55:595-602 ( July )

Occasional review

Interactions between corticosteroids and beta  agonists

D R Taylor, R J Hancox

Department of Medicine, Dunedin School of Medicine, P O Box 913, Dunedin, New Zealand

Correspondence to: Dr D R Taylor e-mail: robin.taylor@stonebow.otago.ac.nz

Received 5 January 2000; Accepted for publication 20 January 2000

The first 150 words of the full text of this article appear below.

    Introduction

Inhaled corticosteroids and beta  agonists are the most frequently prescribed drugs in the management of chronic asthma. Current guidelines emphasise their complementary role. Inhaled corticosteroids are the treatment of choice for all but the mildest of disease. Short acting beta  agonists are recommended for "as required" relief of asthma symptoms, whereas long acting agents are indicated as a supplement to anti-inflammatory therapy if breakthrough symptoms persist.1 Thus, co-prescribing is commonplace. However, despite dynamic interactions between endogenous glucocorticoids and catecholamines in vivo, it is only recently that interest in the possibility of drug interactions has developed. Two topical and clinically relevant questions arise. Firstly, do positive interactions occur, thus providing theoretical justification for current trends to use combination products incorporating a long acting beta  agonist and a corticosteroid? Secondly, do negative interactions occur which might explain the apparent paradox that, despite increasing use of the two therapies over the last 30 years, the overall burden . . . [Full text of this article]




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