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The advent of steroids that can be sprayed directly into the airways provides a way to reduce the systemic effects of these agents, as lower doses can be used.
Indeed, Anthony R. Rooklin, MD, of Crozier-Chester Medical Center, in Media, Pa, recommends instituting spray therapy for children with grade 2 cataracts who are taking oral steroids. He told JAMA medical news, "We have seen reversal of cataracts in children switched to aerosol steroids."
But John Toogood, MD, of the Victoria Hospital in London, Ontario, cautions that high doses of these preparations may also have adverse effects. Of more practical importance, his work shows that best results with aerosols come from four daily doses, rather than from fewer doses with an increased amount of drug per dose.
Toogood's study was an attempt to investigate the practice of reducing the number of daily doses for asthmatics whose compliance is lagging, while possibly increasing the number of puffs per dose. He told
... but aerosol steroids reduce systemic risk. JAMA. 1982;247(19):2658. doi:10.1001/jama.1982.03320440010006
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