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Abstract
Background:
Bronchial asthma and Chronic
Obstructive Pulmonary Disease
(COPD) are major respiratory
diseases in Nepal, with an
increasing prevalence. Inhaled
corticosteroids (ICS) are
the cornerstone of treatment,
reducing exacerbations and
mortality. However, local
adverse reactions such as
oropharyngeal candidiasis,
dysphonia, and throat irritation
can impact medication adherence
and patient quality of life.
Materials
and Methods: This cross-sectional
descriptive study was conducted
at a tertiary care teaching
hospital in Nepal over a period
of six months. Patients diagnosed
with asthma or COPD and prescribed
inhaled corticosteroids were
included. Data on demographic
characteristics, ICS usage,
their dosage duration and
severity of adverse drug reactions
were collected through structured
questionnaires. Those adverse
drug reactions were observed
and preventive measures taken
by patients to counteract
adverse drug reactions were
included. Statistical analysis
was performed using SPSS version
22, with chi-square tests
applied to assess associations
between variables.
Results:
Among 138 patients, 81
(58.7%) reported at least
one ICS-related adverse reaction,
with a higher prevalence in
females (p<0.001) and illiterate
patients (p<0.001). The
most commonly used Inhaled
Corticosteroids was fluticasone
(33.3%), and frequently reported
adverse effects included tooth
decay (35.8%), throat irritation
(20.99%), and tongue abrasion
(19.75%). Higher Inhaled corticosteroids
dosages (200 mcg) and twice-daily
regimens were significantly
associated with increased
adverse reactions (p<0.001).
Self- management strategies
included salt and water gargling
(30.9%), use of antifungal
cream (22.2%), and mouthwash
use (21%).
Conclusion:
ICS-related local adverse
effects are common and influenced
by demographic and drug related
factors. Proper inhaler techniques,
patient education, and preventive
measures can help mitigate
those effects and enhance
treatment adherence.
Key
words: Inhaled corticosteroids,
adverse drug
reactions, oral candidiasis,
dysphonia
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