The pharmacist's role in corticosteroid treatment

Abstract

Corticosteroids are widely used drugs for treatment of several diseases such as bronchial asthma, chronic obstructive pulmonary bronchitis, skin diseases and others. Besides high efficacy the use of corticosteroids was also associated with severe adverse effects. Clinicians are faced with the difficulty to provide rational corticosteroid treatment which comprises maximal treatment efficacy while minimizing the risk of adverse effects. In order to achieve this goal, the role of pharmacists is becoming more important. In the treatment of asthma pharmacists were shown to contribute significantly to the positive treatment outcome by educating patients about: appropriate dosing regimens, the use of peak flow meters, the correct application of inhalation devices and the possible development and prevention of adverse effects. In treatment of atopic dermatitis the role of pharmacist is to provide patients with adequate counseling about skin care and to monitor treatment efficacy. In order to achieve positive treatment outcome it is of outmost importance that pharmacists provide and document pharmaceutical care through establishing, conducting and monitoring of individual treatment plans.

Kortikosteroidi u savremenoj farmakoterapiji nalaze primenu u lečenju niza bolesti poput bronhijalne astme, hroničnog opstruktivnog bronhitisa, bolesti kože i mnogih drugih. Pored visoke efikasnosti primena kortikosteroida je asocirana i sa mogućim ispoljavanjem ozbiljnih neželjenih dejstava. Izazov u kliničkoj praksi predstavlja racionalna terapija kortikosteroidima koja podrazumeva maksimalan terapijski efekat uz minimalan rizik od pojave neželjenih dejstava. U postizanju tog cilja uloga farmaceuta kroz pružanje usluga farmaceutske zdravstvene zaštite postaje sve značajnija. U terapiji astme smatra se da farmaceuti daju značajan doprinos pozitivnom ishodu terapije kroz edukaciju pacijenata o: režimu doziranja lekova, korišćenju merača vršnog protoka, pravilnoj tehnici korišćenja lekova koji se primenjuju inhalacijom i mogućoj pojavi i prevenciji neželjenih dejstava kortikosteroida. U terapiji atopičnog dermatitisa uloga farmaceuta se ogleda kako u savetovanju pacijenta o odgovarajućim merama nege kože tako i u praćenju efikasnosti terapije. U cilju pozitivnog ishoda lečenja od ključnog značaja je da farmaceuti dokumentuju pružanje usluge kroz postavljanje, sprovođenje i praćenje terapijskog plana za individualnog pacijenta.