[Corticotherapy in asthma].

Abstract

The author summarises the modes of action of steroids in asthma and then reviews the treatment of acute asthmatic attacks and long-term steroid treatment. In acute situations steroids are very effective but their onset of action is relatively slow, even when administered intravenously. In practice, beta-2 adrenergic drugs have to be added to steroids for the treatment of acute asthmatic attacks. In long-term treatment, steroids are very effective but the risks of the treatment must also be considered. The first rule is to try and use intermittent treatment, either with alternative steroids or with treatment 5 or 7 days every fortnight. Synthetic ACTH can be added to steroids. Aerosols now play an important role which should become important when the dosages of the puffs are increased. These methods will enable the long-term use of steroids with fewer side effects. This may either be obtained rapidly by beta-2 adrenergic drugs or more slowly with steroids when there are inflammatory lesions of the bronchial mucosa.