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AEROCORT INHALER: WARNINGS AND PRECAUTIONS
Levalbuterol, Beclomethasone (Aerocort Inhaler) is not for use in acute attacks, but for routine long-term management; so, some patients will require a separate levosalbutamol inhaler for relief of acute bronchospasm.
For those patients who are steroid-dependent, it is advisable to commence therapy with beclomethasone diproprionate (Beclate Inhaler) as a separate inhaler.
Patients who have been weaned in the previous few months from long-term systemic corticosteroids need special consideration until the hypothalamic-
pituitary-adrenal system has recovered sufficiently to enable the patient to cope with emergencies such as trauma, surgery or infections. These patients should
also be given a supply of oral steroids to use in an emergency when their airways obstruction worsens.
Paradoxical bronchospasm may occur and should be treated immediately with alternative therapy. Need for more doses of levosalbutamol than usual may be a sign of deterioration of asthma and requires re-evaluation of treatment.
Cardiovascular effects may occur with beta-adrenergic agonists use. Consider discontinuation of levosalbutamol if these effects occur. Use with caution in patients with underlying cardiovascular disorders. Immediate hypersensitivity reactions may occur. Discontinue levosalbutamol if immediate hypersensitivity reactions occur.
Levosalbutamol should be used with caution in patients with coronary insufficiency, hypertension, and cardiac arrhythmias; in patients with convulsive
disorders, hyperthyroidism, or diabetes mellitus; and in patients who are unusually responsive to sympathomimetic amines. Clinically significant changes
in systolic and diastolic blood pressure have been seen in individual patients and could be expected to occur in some patients after the use of any beta-adrenergic bronchodilator.
As with other beta-adrenergic agonist medications, levosalbutamol may produce significant hypokalemia in some patients, possibly through intracellular shunting, which has the potential to produce adverse cardiovascular effects. The decrease is usually transient, not requiring supplementation.
Beclomethasone dipropionate is not for use in acute attacks but for routine long-term management.
Systemic effects may occur with any inhaled corticosteroid, particularly at high doses prescribed for long periods; these effects are much less likely to occur
than with oral corticosteroids. Possible systemic effects include Cushing's syndrome, adrenal suppression, growth retardation in children and adolescents,
decrease in bone mineral density, cataract and glaucoma.
As with all inhaled corticosteroids, special care is necessary in patients with active or quiescent pulmonary tuberculosis.
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