Adrenal Suppression by Aerosol

Abstract

Because of the beneficial and often lifesaving effects of hydrocortisone and its analogues in the treatment of bronchial asthma, a number of attempts have been made to use these steroids by inhalation.^1-8 In the main, the reasons for this approach were twofold: (1) the large proportion of the dose that can be delivered to the site of the desired action in the tracheobronchial tree, and (2) a theoretical consideration that inhalation steroids should have minimal systemic effect. There is little reason to doubt that the first of these reasons has been achieved. However, in review of the literature the second aim of affording minimal systemic absorption has not been reasonably proved. The purpose of this study was to determine whether steroids introduced by inhalation technique have a significant systemic absorption. The product tested was a new inhalant containing dexamethasone, isoproterenol (Isuprel), and an inert propellant (Respihaler). Materials and Methods