A 45-year-old man with mild persistent asthma comes to the office for a routine checkup. He is taking a low-dose beclomethasone inhaler daily and inhaled albuterol, as needed, for the last year. His medical history is otherwise not significant. Family history is significant for diabetes mellitus type 2, hypertension, and obesity. Blood pressure is 136/90 mm Hg and pulse is 80/min. BMI is 26 kg/m². Which of the following is the most likely complication of chronic beclomethasone use in this patient?

Question

Quizplus · Accepted Answer

The local delivery of corticosteroids to the airways by inhalation is a cornerstone of chronic therapy for asthma due to the low incidence of adverse effects. The most common adverse effect associated with the use of any inhaled corticosteroid is oropharyngeal candidiasis (oral thrush). High doses of inhaled corticosteroids can lead to increased systemic absorption and can produce adrenal suppression, cataract formation, decreased growth in children, interference with bone metabolism and purpura. However, these systemic effects are dose-dependent and occur in patients who are on high-dose inhaled steroids for a prolonged period of time (Choices A, C, D, E, and F). Educational objective: The most common adverse effect of inhaled corticosteroid therapy is oropharyngeal thrush (oral candidiasis).

A 45-Year-Old Man with Mild Persistent Asthma Comes to the Office