Occasional review
Interactions between corticosteroids and 
agonists
D R Taylor, R J Hancox
Department
of Medicine, Dunedin School of Medicine, P O Box 913, Dunedin, New
Zealand
Correspondence to: Dr D R Taylor e-mail: robin.taylor@stonebow.otago.ac.nz
Received 5 January 2000; Accepted for publication 20 January 2000
| The first 150 words of the full text of this article appear below. |
 |
Introduction |
|---|
Inhaled corticosteroids and 
agonists are the most
frequently prescribed drugs in the management of chronic asthma.
Current guidelines emphasise their complementary role. Inhaled
corticosteroids are the treatment of choice for all but the mildest of
disease. Short acting agonists are recommended for "as
required" relief of asthma symptoms, whereas long acting agents are
indicated as a supplement to anti-inflammatory therapy if breakthrough
symptoms persist.1 Thus, co-prescribing is commonplace.
However, despite dynamic interactions between endogenous
glucocorticoids and catecholamines in vivo, it is only recently that
interest in the possibility of drug interactions has developed. Two
topical and clinically relevant questions arise. Firstly, do positive
interactions occur, thus providing theoretical justification for
current trends to use combination products incorporating a long acting
agonist and a corticosteroid? Secondly, do negative interactions
occur which might explain the apparent paradox that, despite increasing use of the two therapies over the last 30 years, the overall burden
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