Paper I — 2025 March (Supplementary (SAY)) (2019 Scheme) — Q14
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Paper I
2025 March (Supplementary (SAY)) (2019 Scheme) · 100 marks · 180 min
Question
Explain the adverse effects and role of inhaled steroids in Bronchial asthma.
Q144 marksShort Answers
Answer
Role of inhaled corticosteroids in bronchial asthma
Inhaled corticosteroids (Budesonide, Fluticasone) are the cornerstone of long-term controller therapy in persistent asthma. They reduce airway inflammation by suppressing inflammatory cell recruitment/activation, downregulating cytokine production, and upregulating beta-2 receptor expression/responsiveness — reducing airway hyperresponsiveness and the frequency/severity of exacerbations over time. Delivered locally to the airway, they achieve high local anti-inflammatory activity with comparatively low systemic absorption, unlike systemic steroids. They have no role in relieving an acute attack already in progress (slow onset, no bronchodilator action) — used for prevention/control, not rescue.
Adverse effects: oropharyngeal candidiasis and dysphonia (local effects — reduced by rinsing the mouth after use and using a spacer device), and — with high-dose, long-term use — reduced growth velocity in children, adrenal suppression, and reduced bone mineral density, though these systemic effects are substantially less than with oral/systemic corticosteroids at an equivalent anti-inflammatory dose.
