[Glucocorticosteroid therapy in bronchial asthma with special reference to the prevention of life-threatening bronchial obstruction in high-risk asthma].

The treatment of bronchial asthma with glucocorticosteroids requires consideration of unequivocal principles which include strong indication, considering the individual risk-benefit-relation. Glucocorticosteroids should be fitted in a medicamentous-therapeutic hierarchy. Inhalable glucocorticosteroids hardly cause systemic side effects, so they are very suitable for the continuous treatment, if the need in glucocorticosteroids is low. The indication for systemic application of glucocorticosteroid, their side effects, relative contraindications and pharmacological interactions are given. Careful analyses of cases of death, caused by bronchial asthma in accordance show that an inadequate glucocorticosteroid-therapy was the most important avoidable factor. The attention of the clinicians must be directed on a small group of patients characterised by high risk of death ("high-risk-asthma"). These patients, having certain clinical signs, need not only special intensive care, but also experienced, early and sufficient treatment with glucocorticosteroids to prevent life threatening situations.