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Drug Name beclomethasone dipropionate (be kloe meth' a sone) ApoBeclomethasone (CAN), Beconase AQ, Propaderm (CAN), QVAR Pregnancy Category C Drug classes Corticosteroid Glucocorticoi d Hormone

Dosages Topical/Cutaneous Skin disorders Adult: Apply a 0.025% cream/ointment onto affected area. Nasal Prophylaxis and treatment of allergic and non allergic rhinitis Adult: 100 mcg bid or 50 mcg 3-4 times daily in each nostril. Max: 400 mcg daily. Inhalation Prophylaxis of asthma Adult: Initially, 600-800 mcg daily. Maintenance: 400 mcg daily in 2-4 divided doses. Child: As dipropionate: 50 or 100 mcg bid-qid or 100 or 200 mcg bid. Inhalation Severe asthma Adult: 250 mcg four times daily or

Therapeutic Actions Beclometaso ne controls the rate of protein synthesis, depresses the migration of polymorphon uclear leukocytes, fibroblasts, reverses capillary permeability and lysosomal stabilisation at the cellular level to prevent or control inflammation.

Indications Respiratory inhalant use: Control of bronchial asthma that requires corticosteroids along with other therapy Intranasal use: Relief of symptoms of seasonal or perennial rhinitis that respond poorly to other treatments; prevention of recurrence of nasal polyps following surgical removal

Adverse effects Loss of skin collagen and SC atrophy; local hypopigmentati on of deeply pigmented skin; dryness, irritation, epistaxis, rarely ulceration or perforation of the nasal septum; smell and taste disturbances; hoarseness and candidiasis of the mouth or throat.

Contraindication s Hypersensitivity. Acute infections uncontrolled by antimicrobial chemotherapy.

Nursing considerations Assessment History: Acute asthmatic attack, status asthmaticus; systemic fungal infections; allergy to any ingredient; lactation; untreated local infections, nasal septal ulcers, recurrent epistaxis, nasal surgery or trauma Physical: Weight, T; P, BP, auscultation; R, adventitious sounds; chest radiograph before respiratory inhalant therapy; examination of nares before intranasal therapy Interventions BLACK BOX WARNING: Taper systemic steroids carefully during transfer to inhalational steroids; deaths resulting from adrenal insufficiency have occurred during and after transfer from systemic to aerosol steroids. Use decongestant nose drops to facilitate penetration of intranasal steroids if edema or excessive secretions are present. Teaching points This respiratory inhalant has been prescribed to prevent asthmatic attacks, not for use during an attack.

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500 mcg bid. May be increased to 500 mcg 3-4 times daily if necessary. Max: 2 mg daily.

Allow at least 1 minute between puffs (respiratory inhalant); if you also are using an inhalational bronchodilator (isoproterenol, albuterol, metaproterenol, epinephrine), use it several minutes before using the steroid aerosol. Rinse your mouth after using the respiratory inhalant aerosol. Use a decongestant before the intranasal steroid, and clear your nose of all secretions if nasal passages are blocked; intranasal steroids may take several days to produce full benefit. Use this product exactly as prescribed; do not take more than prescribed, and do not stop taking the drug without consulting your health care provider. The drug must not be stopped abruptly but must be slowly tapered. You may experience these side effects: Local irritation (use the device correctly), headache (consult your health care provider for treatment). Report sore throat or sore mouth.

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