Corticosteroides II: Inhalados, intranasales, oftálmicos y óticos

Corticosteroides II: Inhalados, intranasales, oftálmicos y óticos

1. C}??]}???}]? II
INHALADOS U INTRANASALES U OFTÁLMICOS Y
ÓTICOS
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7. F?u}]v ?]
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11. Laurence L. Bruton, JR}vS o?} X K]?R L X P?l? X C?]??o} 2? FARMACOTERAPIA DEL ASMA Bradley J. Undem. Goodmany Gilman. Las
bases farmacologicasde la terapeutica.
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12. La •?o]]v local de medicamentos ]vRo}? ?
P
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–Reduciro}?efectosadversosanivelgeneral X
Laurence L. Bruton, JR}vS o?} X K]?R L X P?l? X C?]??o} 2? FARMACOTERAPIA DEL ASMA Bradley J. Undem. Goodmany Gilman.
Las bases farmacologicasde la terapeutica.
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13. Eo•P?}??]?}??ou}v??v???}]]vRo}
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14. Un factor determinante de la • introduccinde cual?uier
sustancia en ???culasa los pulmones es el ?uyo X
Laurence L. Bruton, JR}vS o?} X K]?R L X P?l? X C?]??o} 2? FARMACOTERAPIA DEL ASMA Bradley J. Undem. Goodmany Gilman. Las
bases farmacologicasde la terapeutica.
AN10 ?use depositarAn
en la boca y en la
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?? ? ?Rov
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15. AuA?• del]Au??}dela???_?o U}??}?
factores??u]vveldepositoefica?de
medicamentosenelA?}o?}v??]o P
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S• recomiendainspirardeuv???}(?v?
ov? U??v?elo]v?}??v? ?a ? ?
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(A?u}]vRo} X
Laurence L. Bruton, JR}vS o?} X K]?R L X P?l? X C?]??o} 2? FARMACOTERAPIA DEL ASMA Bradley J. Undem. Goodmany Gilman. Las
bases farmacologicasde la terapeutica.
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16. E???}] ]vRo} ]o
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D]??}?]}v?} o}u??}v ~DBP lu}v}??}?]}v} ~MPB
H]?}(o?}?}ov}? ~HFA
DPI ~ ?}o?} ?}
C]o?}v] ~CIC lD?CIC
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17. J]v?} Ru}? G}v?Ao? X C}??]}]? ]vRo}? v o ???u]v?} o ?u P ???v? ? (????} M]]vR??]??}?] ? ? ? ? U ? ~ ? P ? ? r ? ?
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18. IvRo}?? }?]? u]
Los• ??]u?}?]vRo}??conten_an
clorofluorocarbono ~CFC como??}?ov? X
•F?luegosustituido?}?R]?}(o?}?}ov}?
~HFA o}?cuales reducen
considerablementeelimpactou]v?o?
?vdeo?diferenciasprincipales???la
solucinconHFA??u]?incluir???culas
de ? X ??u X
Laurence L. Bruton, JR}vS o?} X K]?R L X P?l? X C?]??o} 2? FARMACOTERAPIA DEL ASMA Bradley J. Undem. Goodmany Gilman. Las
bases farmacologicasde la terapeutica.
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19. IvRo}?? }v ?}o?} ?}
U?]o]?v• o?}?}Po?}?v?}o?}}u}?R_?o} X
D??v?i?• Pv?]??v(o?i}]?P?v??????v?uv?
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L}?• v]y}?}?? Uo}?v]v}???]v????]}v?P???
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R?]?? M?]v C]v]? F?u ??]? U ?}o X ? ? U v?u X ? U i?o]} r???]u? U ? ? ? ?
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20. Eo]u]v]v
M?}o]?]v • ? o]u]v]v ?}? o R_P} X
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(?}? ??v?]}? ? ui}? ?? _v]??? ??]} X
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(?vuv?v ?? o]vR?]?? M?]v C]v]? F?u ??]? U ?}o X ? ? U v?u X ? U i?o]} r???]u? U ? ? ? ?
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21. U?]o]?}?• }u}??]u?o_v??? ??]v?]v??}v?u X
Oi?]?}?• P
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o }v??}o o
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(?vuv?v ?? o]vR?]?? M?]v C]v]? F?u ??]? U ?}o X ? ? U v?u X ? U i?o]} r???]u? U ? ? ? ?
A?uv??oo]?]o?]v??????}?]??vo}?}?]o
u]}?]v(ou?}?]}???uvv??vo]?}???]????o?_
???]??}?]??}?]}vv?v? ?]]?????]oo(?v]v
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22. C}??]}???}]?]vRo}?
Adolescentesy ?o?}? ~AH12 y}?)
E?? v} ? ?v ?o ??]?ov] U ?]v} }u??]v o_v] – estimada
Las dosis altas son – arbitrarias U ??} ?? o u?}?_ ICS ?}v o}? ?ue con el uso prolongado se asocian con un mayor riesgo de efectos
??v?]}? ?]?? u]}?
C}??]}???}]]vRo} D}?]?]?]total (mcg)
Bi M] Alta
D]??}?]}v?}de beclometasona ~CFC ? ? ? W ? ? ?>500 W1000 >1000
Dipropionatode beclometasona(HFA) 100 W200 >200 W400 >400
Budesonide (DPI) 200 W400 >400 W800 >800
Ciclesonide (HFA) 80 W160 >160 W320 >320
Propionatode fluticasona(DPI or HFA) 100 W250 >250 W500 >500
Furoatode fluticasona < 100 >100-200 > 200
Furoatode mometasone 110 W220 >220 W440 >440
Acetonidodetriamcinolona 400 W1000 >1000 W2000 >2000
GINA 2015, Box 3-6 (1/2)
Global Initiative(}?A??Ru. Global S???P?(}?A??RuMvPuv? v P??v?]}v ? ? ? ? X D]??}v]o
v P ??? XP]v??Ru X}?P
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23. C}??]}???}]?]vRo}?
N]y}? ? W11 y}?
E?? v} ? ?v ?o ??]?ov] U ?]v} }u??]v o_v] ??]u–
L u?}? ??? o v(]]} o_v]} o – CSI se ve a dosis i?
Las – }?]? o?? ?}v ?]???]? U ??} ?? o u?}?_ CSI ?}v o}? ?? }v o ??} ??}o}vP} ? ?}]v }v ?v u?}? ?]?P} (?}?
??v?]}? ?]?? u]}?
Corticoesteroideinhalado Dosisdiariatotal (mcg)
Baja Media Alta
Dipropionatode beclometasona(CFC) 100 W200 >200 W400 >400
Dipropionatode beclometasona(HFA) 50 W100 >100 W200 >200
Budesonide (DPI) 100 W200 >200 W400 >400
Budesonide (nebules) 250 W500 >500 W1000 >1000
Ciclesonide (HFA) 80 >80 W160 >160
Propionatode fluticasona(DPI) 100 W200 >200 W400 >400
Propionate defluticasona(HFA) 100 W200 >200 W500 >500
Furoatodemometasona 110 AH ? ? ? W<440 AH ? ? ?
Acetonidode triamcinolona 400 W800 >800 W1200 >1200
GINA 2015, Box 3-6 (2/2)
Go}o Iv]?]?]? (}? A??Ru X Go}o S???P? (}? A??Ru MvPuv? v P??v?]}v ? ? ? ? X D]??}v]o v P ??? XP]v??Ru X}?P
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24. E(?}? ???}? X
Efectos locales Efectos sistémicos
Cv]]?]? }?o X•
D]?(}v• _ X
R}v??? X•
F?]vP]?]? X•
D](]?o? ?? ???]??•
G?Pv? ]??]? X•
S X•
D?u?]?]? • ??]}?o
H]????}(] u???o? ovP? X•
Ao??]}v? o }u?}??u]v?} X•
O??}?}?}?]? X•
R?]v o ?]u]v?} ?} v v]y}? X•
D?}?v? v o u?}o]?u} • o_?]}? X
C????•
Go?}u •
S????]• v?v}}??}???] X
Hu?}u? ? oP?u]v?} o ?]o X•
Ao]v R X R}?_P?? rO?}?} U J?] F]P??} P X J??] V]oo A X E???}]? ]vRo}? v ?u X A???}? (?u}oP]}??? (?vuv?v
?? o]vR?]?? M?]v C]v]? F?u ??]? U ?}o X ? ? U v?u X ? U i?o]} r???]u? U ? ? ? ?
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25. D? X G??uAv
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26. E(]] ? ?P??] ??]}? ???}]? ]vRo}? v
o ???u]v?} ?]v?? }v ?u
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R?]?? M?]v C]v]? F?u ??]? U ?}o X ? ? U v?u X ? U i?o]} r???]u? U ? ? ? ?
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27. E(]] ? ?P??] ??]}? ???}]? ]vRo}? v
o ???u]v?} ?]v?? }v ?u
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o]vR?]?? M?]v C]v]? F?u ??]? U ?}o X ? ? U v?u X ? U i?o]} r???]u? U ? ? ? ?
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28. E(]] ? ?P??] ??]}? ???}]? ]vRo}? v
o ???u]v?} ?]v?? }v ?u
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(?vuv?v ?? o]vR?]?? M?]v C]v]? F?u ??]? U ?}o X ? ? U v?u X ? U i?o]} r???]u? U ? ? ? ?
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29. R????? o}? }??]}]? ]vRo}? ? uv]?u}?
u}o?o?? o ??]} r??]??v]
S• ??]u??o?}??v ? ? r ? ?A9?]v??}v?uv}
???v?v?v???????o???u]v?}}v???}]?
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? ?•A9??]?vo}?]?uA?]u??o}P??o}v??}o X
• ?A9?}v}??]}?v]v?? X
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(?vuv?v ?? o]vR?]?? M?]v C]v]? F?u ??]? U ?}o X ? ? U v?u X ? U i?o]} r???]u? U ? ? ? ?
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30. R?]??v] o}? ???}]?
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?}??}v}]o?}?u???]v}??????u]v?}}v ? ?uP
]?]}???v]?}o}v}??]?ov???v? ? ?_? X
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o]?}?}??]}??}?]v ~R?R ? X
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31. C}??]}???}]?
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32. L}?• }??]}]?]v??v?o?Rv?]}??]o]?}?vo
???u]v?}o?]v]?]????]v]?]}?o
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33. ARIA• ?(]?lau?li?acincomo
??}(]o?]?o??? uticadeo}?
corticosteroidesnasales??
controlarlau?}?_adeo}??_v?}u?
nasalesdelaRA X
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de??]u?l_nea??laRA
u}?agrave X
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Tur?u_a
MACVIA rARIA Sv?]voN??}?K(}?allergic?R]v]?]? ~MASK r?R]v]?]? P ?Rnew generationguideline]u?ouv??]}vArticlein Allergy | July ? ? ? ?
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34. Mv]?u} ]v X
L}?• }??]}]?]v??v?o???vu]v?o?P?o]vo?_v??]?
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u}?o?o????]vPv?]v?}o??}?vo??????]v(ou?}?] X
L}?• }??]}]?]vR]vo??]vo}?o]v(}]?}?T U?]?vo?uv?}
o?]v??o?]v?IL r ? UIL r ?IL r ? ? U]vR]vo]v.o??]v}?]v}0o] Uo
?????]?v]o}?}?]v(]o}??o??}?]vIL r ? X
D??P?K?l]v X P??? o _ o ???] }v }??]}]? ]v??v?o?D???uv?}( O?}?R]v}o??vP}o}P? U Uv]???]??}( O?uvP?] U ? ? ? ? ? U
E?l]?R]? U T????_
D]?u]v?]v
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35. •D]?u]v??vov?u?}u?(P}?
?]??o???????]uvoo]?]vIL r ? U
(?}?v?}?]???u}?oo(?(?}?
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D??P?K?l]v X P??? o _ o ???] }v }??]}]? ]v??v?o?D???uv?}( O?}?R]v}o??vP}o}P? U Uv]???]??}( O?uvP?] U ? ? ? ? ? U
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36. Go?}}??]}]? ]v??v?o???]}?
S}v• ??ouv?o???]uv?v]u]v?}uA?(]???
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37. Eo•??]u?}??]}]??]}??]o]?}(?o?u??}v
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L•?}?]v?]?? u]?o? X
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38. L}?• }??]}???}]?]v??v?o??}vo}?]v??? ??]
uA?(]???o???u]v?}o?]v]?]?o ?P]?v}
o ?P] X
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C}v?v– ?v}v?_v?}u??v}vo???u]v?}v?R]??u_v]} X
S? H?}??]JA ? }o X R?]?? Ao?P] M ?]}V}o?uv ? ? U N?u X ? U v}?]u? r]]u? U ? ? ? ?
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39. S?• actividadv?]]v(ou?}?]?u] nseRevaluado
u]v?elgradode]vR]]]ndecitocinas X
Los• estudiosinvitro Urelacionadosconlaliberacinde
R]??u]v Umuestranu?}?eficaciacon P
Fo??]?}v–
M}u??}v–
Budesonida–
Beclometasona– AAtriamcinolona X
Jose? Av?}v]} S? Ha?ouri U C?o}? o T}?? Gon?Ao?, Ana Luisa L??Gon?Ao? U R]?} Álvare?VP P???]?]nde corticosteroides
intranasalespara la ?]v}}vi?v?]?]?]?al rgicay rinosinusitisen la edad ?]Atrica X R?]?? Ao?P] M xicoV}o?uv ? ?, N?m. ?, noviembre r
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40. u}u??}v? (o??]?}v
u????v u?}? ]vR]]]v
o? ]v??o?]v? ~IL r ? IL r ? X
??}v] U o}u??}v ?
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]vR]v o IL r ? IL r ? U ??}
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]v??v?o??? o ?]v}}vi?v?]?]?]?o ?P]? ?]v}?]v??]?]?v o ?]A??] X R?]?? Ao?P] M ?]}V}o?uv ? ? U N?u X ? U v}?]u? r
]]u? U ? ? ? ?
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41. L•(]]o}?}??]}???}]?]v??v?o??v??
P?}o]?}(]o]] X
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o?i]}???]??}?]} Uu?}?}??]v?(]v]?v]v
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o]? X
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]v??v?o??? o ?]v}}vi?v?]?]?]?o ?P]? ?]v}?]v??]?]?v o ?]A??] X R?]?? Ao?P] M ?]}V}o?uv ? ? U N?u X ? U v}?]u? r
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42. L}? }??]}???}]?
o?uv? o]?}0o]}? P
P?}?]}v?} (o??]?}v
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D]??}?]}v?} o}u??}v
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43. Eo• }i?]?}o???]?ov??o?}vv??]}v???vo}?
???}??vou?}?v?o?o]u]??ov?](A?u}????o
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44. D? X G??uAv
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45. Eo•}??]}???}]]v??v?o]o?v?o??}?v]?(]v]?}?
o}????}??Po?}}??]}]?o}o? U?i?}?]]?]?? u]}v
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J}?? Av?}v]} S? H?}??] UC?o}? o T}?? G}v?Ao? UAv L?]? L??G}v?Ao? UR]?} Áo???VP P???]?]v }??]}???}]?]v??v?o?
?? o ?]v}}vi?v?]?]?]?o ?P]? ?]v}?]v??]?]?v o ?]A??] X R?]?? Ao?P] M ?]}V}o?uv ? ? U N?u X ? U v}?]u? r]]u? U ? ? ? ?
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46. L• (o??]?}v?u}u??}v?]vv
]}]??}v]]o]?]?? u]u_v]u V?}?o}?v?} Uo}?
R(?]?}???o???u]v?}ov(?u
?v]vo?}o]v?]A??] X
J}?? Av?}v]} S? H?}??] U C?o}? o T}?? G}v?Ao? U Av L?]? L??G}v?Ao? U R]?} Áo???VP P???]?]v }??]}???}]?
]v??v?o??? o ?]v}}vi?v?]?]?]?o ?P]? ?]v}?]v??]?]?v o ?]A??] X R?]?? Ao?P] M ?]}V}o?uv ? ? U N?u X ? U v}?]u? r
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47. J}?? Av?}v]} S? H?}??] U C?o}? o T}?? G}v?Ao? U Av L?]? L??G}v?Ao? U R]?} Áo???VP P???]?]v }??]}???}]?
]v??v?o??? o ?]v}}vi?v?]?]?]?o ?P]? ?]v}?]v??]?]?v o ?]A??] X R?]?? Ao?P] M ?]}V}o?uv ? ? U N?u X ? U v}?]u? r
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48. E(?}? ???}? X
MA? (??v?? P
I??]?] { v
R??? v?o {
B} ? {
E?]???]? {
E??}?v?}? {
M}o??]? { (?_vP?
{NA???
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A o?P} ?o?} P
S????] { vo i R]?}?Aou} rR]?.?]? rPoAv?o?
??????vo? ~HHS X
Ao??]}v? { R]?}o??}o_?] X
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C???? X {
H]???v?] { v???]o X
R???} o ?]u]v?} X {
M]}?? { X
Ao??]}v? }v???o? X {
D??P?K?l]v X P??? o _ o ???] }v }??]}]? ]v??v?o?D???uv?}( O?}?R]v}o??vP}o}P? U Uv]???]??}( O?uvP?] U ? ? ? ? ? U
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49. E?]??• preocupacinacercadelimpactodel
???u]v?}prolongadoenlamucosanasal,???
produce??}(] X
•L}?estudiosinvivo?}?vsuinocuidadenla
mucosa X
–Se??u]v?}vo}?cambiostisularesenlamucosanasal
depacientescon?]v]?]?al rgica??vv U???}?con
(??}?}demometasona ~ ? ? ??P ld_a??v? ? ?meses)?
sedemostro? Uu]v?biopsiasposterioresal???u]v?} U
?vdisminucin]u?}??v?eneln?u?}deeosin(]o}??
mastocitos???}?v}delamucosaasuestadov}?uo X
–Noorigin??}(]del?]?o]}nasal X
Jose? Av?}v]} S? Ha?ouri U C?o}? o T}?? Gon?Ao?, Ana Luisa L??Gon?Ao? U R]?} Álvare?VP P???]?]nde corticosteroides
intranasalespara la ?]v}}vi?v?]?]?]?al rgicay rinosinusitisen la edad ?]Atrica X R?]?? Ao?P] M xicoV}o?uv ? ?, N?m. ?, noviembre r
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50. NLOS CORTICOESTEROIDES INTRANASALES
CAUSAN ALTERACION DEL EJE H]?}?Aou} r
H]?(]?]? rS?????vo M
L}?• ???]}?o_v]}???vo]??}vo}?(?}?o}?
}??]}???}]?v?o??}?o_v](?v]v
?ov}??o?}v(?}??]Pv](]?]?}? X
D]???}?• ???]}?u}????}v??o}?}??]}???}]?
i?v(?}?u_v]u}??}?oiHHA?v}?}v
u]v]???}?v?v?v]}?]??}?ouyv X
L•u]v]???]v?v}?]?]?]?}?ouyv
?u??]u?}??v?vo}?v]y}??????o? Uv
??]v?o??]voR}?u}v?]u]v?}?
??o?A?]o?v}???v X
Sl}v?DP U RRo(?l?GS U Mo???EO U CR??]v?l?P U ? o X D??]}v}( P?}??R??????]}v]v R]o?v??]vP???uv??]?R]v??v?o o}u?R?}v]??}?]}v? X
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51. NLOS CORTICOESTEROIDES INTRANASALES AFECTAN
EL CRECIMIENTO Ó
? ? ? ?• laFDA}?v??o}?corticoesteroides
]vRo}?tuvieranlao?vderiesgoderetraso
enelcrecimiento X
Un• estudiocon]??}?]}v?}debeclometasona
intranasal, ? ? ?v]y}?v??seis?nuevey}?de
edadse????}vconbeclometasona ~ ? ? ??P}?
vecesal_ oplacebo??v??vy} X
Noventa• v]y}?completaronelestudio?o}???
recibieronelcorticosteroidetuvieron??}u]}de
crecimientode ?cm,u]v?????o}?delgrupo
placebotuvieron ? X ?cm ~diferencia???y??}
??_??]uv?significativa,pAM ? X ? ?) X
L]??}??RBJ U Jl?}v CM X S(?? }( ]vRo v ]v??v?o }??]}???}]? P o??}v? (}? ?R v? u]oovv]?u X D??P S( ? ? ? ? V ? ? ~ ? P ? ? r ? ?. .
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52. Ev• oy} ? ? ? ????o]?v???]}??]vo??
? ?v]y}?v??????v??y}? X
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u}u??}v ~ ? ? ??P l_ }?o} X
ORv?• ?}??]v??}u?o??}vo???]} X
D??? ?• ?vy}?P?]u]v?}v}?u}???
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D?? L U M]? WC X R]?l }( ??? u}vP ???? }( ]v??v?o }??]}???}]? X J Aoo?P? Co]vIuu?v}o ? ? ? ? V ? ? ? P ? ? ? r ? X
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53. NLOSCORTICOESTEROIDESINTRANASALESTIENEN
EFECTOSOCULARES Ó
N}?Ru}???}?]o?vo???]v]v??}?o??
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L}????]}???}???]?}?o}?}??]}???}]?
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???}oo}Po?}u
R?v?PH U W]vP???RvM U ?v B?oJH X E((]?v ?(?? }( ]o?}v]v?o ???? (}??R???uv?}( ??}vooo?P]?R]v]?]? X J Aoo?P?Co]vIuu?v}o ? ? ? ? V ? ? ? P
? ? ? ? r ? X
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54. C}??]}???}]?
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55. L}?• }??]}???}]?}v??]???v?v}o}?
P???}?(?u}oP]}?uA???}?v
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Eo•}??]}???}]}(?Aou]}?o???u]v?}
uA???}vo]vGu]v}?o? X
Euv?o B??AL}????v? U F?u_vVA????C???} X T??u]v?}? ??]}?}?o?? P ??]?]v X S]??u
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56. Mv]?u} ]v
A??v• o}??v}o(}?u]v
A]}???]v]} X
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o??u]o]???o??
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o]?}?}uoo}?PMN? X
Euv?o B??AL}????v? U F?u_vVA????C???} X T??u]v?}? ??]}?}?o?? P ??]?]v X S]??u
N]}vo So? X V}o?uv ? ? U N} ? l ? ? ? ?
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57. L? • v(?u? }?o?? v o? ?? ??v ?? o ??]u? ?ov
??? ??]} P
U?– _?]? X
C}vi?v?]?]?]?– o ?P] X
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R?v– o]v(ou]v?}????uA?]??? ?}??]}v?}(?Aou]? X
S]???]o]?v(}?u?uv?}??u]?v}v????o?]?]v??}
?(}???vuv??]vv?vu?Pv??? ??]}???R}??o}?R?}}
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? l ? ? ? ? XAo(?} J X C ??? VoA?o X F?u}o}P_ }(?ou}oP] X Go?}}??]}]? X R? C?vO(?ou}o ? ? ? ? V ? ? ~ ? r ? P ? ? r ? ?
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58. L•?_u]v]???]vuA???]o]??o??] P
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o?}o?]v}????v?]v U????}?}?]}v??v}v??}??}o}vP}
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59. •L }?].]v? v (?v]v o P?? o ??}?}
]v(ou?}?]} P
P?}?} ]v(ou?}?]}
o? } u}?}
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P?}?} ]v(ou?}?]}
P??
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D]?u]v?]? {
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?v ?_ X
Euv?o B??AL}????v? U F?u_vVA????C???} X T??u]v?}? ??]}?}?o?? P ??]?]v X S]??u
N]}vo So? X V}o?uv ? ? U N} ? l ? ? ? ?
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60. S• ?}u]vo??}???}]?i?}?v]
??]v]v??u](?}????]?]
u]v?o}}??]}]??o?_}?o}??v??o X
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v??]o]???o}?uv}??}?v] X
Euv?o B??AL}????v? U F?u_vVA????C???} X T??u]v?}? ??]}?}?o?? P ??]?]v X S]??u
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61. D?u??}v P
G?v {?}?v?]]v(ou?}?]} X
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S {??]o]?vv(?u?
o ?P]?]v(ou?}?]?o
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????]?]? U
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u?P]vo????v? X
A?o]? { ? r ?P}?? ? r ?
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? r ? ?R}?? X
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?o] ? r ? ? R}?? X
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62. Fo?}?}u?}o}v
Av {Ao}P}o??}P???}v X
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o?]?]? U???}?}?]v(ou?}?]}?
?v]}? ~}vi?v?]?]?]? Uo(?]?]??
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o? o]?}?}o?]o] X
L} ?? o }v(]? { ?v??]v
u] v]?o }?o? X
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63. E(?}? ???}?
•Eo ??} ??]}}v?]v?} ??
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64. C}v??]v]]}v?
•Q???]?]? v?_?] ~R??? ?]u?o }?o? X
o?]}v? ? ??]}v? uAv]? o • }i} X
Ao(?} J X C ??? VoA?o X F?u}o}P_ }(?ou}oP] X Go?}}??]}]? X R? C?vO(?ou}o
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65. C}??]}???}]?
?]}?
D? X G??uAv
CRAIC M??

66. Uso de esteroides ?]}?
Trastornos del • o_do]v??v} X
Hipoacusia.•
Ac•?(v}? X
Alteraciones del e?uilibrio. •
P?} M??nE??o??]R U D? X Co?? E??o??]R U D? X P?} R X E??o??]R. Transtympanicsteroids(tts). Historicalreviewand
personnelexperienceREVISTAFASO AHO ? ? rNo ? r ? ? ? ?
D? X G??uAv
CRAIC M??

67. Eo• o_do]v??v}respondeal???u]v?}sist micocon
esteroides X
•Laexperienciaconesteroidestrans?mpAnicos?o]u]? X
•Existenbasescomo??(]?u???eno?alteracionesdel
o_do]v??v}o}?esteroides?]vv?v?}o]u?}??v? X
P?} M??nE??o??]R U D? X Co?? E??o??]R U D? X P?} R X E??o??]R. Transtympanicsteroids(tts). Historicalreviewand
personnelexperienceREVISTAFASO AHO ? ? rNo ? r ? ? ? ?
D? X G??uAv
CRAIC M??

68. S• Rvidentificadoreceptores??o}?glucocorticoidesenla??o??o
delacclea X
•Lav?]uNa lKATP? U??intervieneenlaproduccindelpotencial
endococlear?enlaregulacindelcontenidodeaguae]}v?enelo_do
]v??v} X
•Tambi nestApresenteenla??o??odelaccleaeinteract?acono}?
receptores??o}?glucocorticoides X
P?} M??nE??o??]R U D? X Co?? E??o??]R U D? X P?} R X E??o??]R. Transtympanicsteroids(tts). Historicalreviewand
personnelexperienceREVISTAFASO AHO ? ? rNo ? r ? ? ? ?
D? X G??uAv
CRAIC M??

69. Los esteroides, utili?ados por • ??? ?]u?Av]}? para
ui}?? o}? ? rtigosen la enfermedad de M ni? X
F??}v ??}? • por Sl?en ? ? ? ?, SRand Ge en
? ? ? ?, SRen 1??? ~ ? ?) y S]????]vet al en ? ? ? ?.
P?} M??nE??o??]R U D? X Co?? E??o??]R U D? X P?} R X E??o??]R. Transtympanicsteroids(tts). Historicalreviewand
personnelexperienceREVISTAFASO AHO ? ? rNo ? r ? ? ? ?
D? X G??uAv
CRAIC M??

70. SR• ?al,??iv}conlau]v]???]vcombinada?}?
????]u?Av]}???}??_aintravenosacondexametasona
?(]?v?? P
Interact– ?aconreceptoresanivelnuclear?selogranconcentraciones
mA?o??aniveldelsacoendolinfAtico X
? ?– X ?A9tuvoui}?_aenlaaudicin??v ? ? X ?A9decontroldeo}?
? rtigosen ? ?pacientescondistintosestadiosdelav(?ude
M ni? X
P?} M??nE??o??]R U D? X Co?? E??o??]R U D? X P?} R X E??o??]R. Transtympanicsteroids(tts). Historicalreviewand
personnelexperienceREVISTAFASO AHO ? ? rNo ? r ? ? ? ?
D? X G??uAv
CRAIC M??

71. Los• esteroidesRvsidoelegidos?}?susconocidas
??}?]?v?]v(ou?}?]??neuroprotectoras U??iniciar
el???u]v?}????]u?Av]} X
C}v• estem ?}}selogranevitaro?????biolgicas??
lallegadadeladrogaalo_do]v??v}?se}?]vvo??
concentracionesdelamismaen l Uconaliviodeo}??_v?}u?
a???? X
P?} M??nE??o??]R U D? X Co?? E??o??]R U D? X P?} R X E??o??]R. Transtympanicsteroids(tts). Historicalreviewand
personnelexperienceREVISTAFASO AHO ? ? rNo ? r ? ? ? ?
D? X G??uAv
CRAIC M??

72. C}vo??]}v?
Eo•??(]o?P??]o}????}]??vo
?]u?}????}?o?}?]?u?o? X
L}?• ???}]?]vRo}??}vo??]u?}?]v
??? ??]vo???u]v?}o?uv?}?o?
???}v?P??}??(]?o?}?]?
??? ??]??}uv? X
D? X G??uAv
CRAIC M??

73. L}?• ???}]?v?o??}vo}?]v
??? ??]uA?(]???o???u]v?}
o?]v]?]? X
S•?o??o?]?P}v(]]}??]o]??
???}]? X
D? X G??uAv
CRAIC M??