Proper use of aerosol corticosteroids to control asthma.

Aerosol glucocorticoids are highly effective in the treatment of bronchial asthma. Clinically apparent systemic hypercortisolism is virtually nonexistent in patients who receive such therapy, although local effects of candidiasis or dysphonia may occur. Treatment failures can often be attributed to poor patient compliance or incorrect use of the pressurized aerosol inhaler. The addition of a spacer device to the inhaler improves the technique and the results in many patients. Furthermore, many patients with asthma require 2 or 3 times the conventional dose of aerosol corticosteroids for optimal control of pulmonary function. Careful coaching is essential for the successful use of aerosol corticosteroids.