"Pacienti by m\u011Bli b\u00FDt informov\u00E1ni o profylaktick\u00E9m charakteru l\u00E9\u010Dby inhala\u010Dn\u00EDm budesonidem a o nutnosti pravideln\u00E9ho pou\u017E\u00EDv\u00E1n\u00ED p\u0159\u00EDpravku, a to i v\u00A0dob\u011B bez symptom\u016F. Budesonid neuvol\u0148uje akutn\u00ED bronchospasmus, ani nen\u00ED vhodn\u00FD k\u00A0prim\u00E1rn\u00ED l\u00E9\u010Db\u011B status asthmaticus nebo jin\u00E9 akutn\u00ED astmatick\u00E9 epizody.\nUpozorn\u011Bn\u00ED\nPacient\u016Fm s\u00A0formou plicn\u00ED tuberkul\u00F3zy v\u00A0klidov\u00E9m stavu, s\u00A0pl\u00EDs\u0148ovou \u010Di virovou infekc\u00ED\u00A0d\u00FDchac\u00EDch cest je nutn\u00E9 v\u011Bnovat zvl\u00E1\u0161tn\u00ED p\u00E9\u010Di.\nZ\u00A0d\u016Fvodu mo\u017Enosti pl\u00EDs\u0148ov\u00FDch infekc\u00ED je nutn\u00E1 tak\u00E9 zv\u00FD\u0161en\u00E1 opatrnost p\u0159i l\u00E9\u010Db\u011B pacient\u016F trp\u00EDc\u00EDch plicn\u00EDmi chorobami (bronchiektaziemi a pneumokoni\u00F3zou).\nP\u0159i akutn\u00ED exacerbaci astmatu m\u016F\u017Ee b\u00FDt nutn\u00E9 d\u00E1vku Miflonidu zv\u00FD\u0161it nebo na kr\u00E1tkou dobu roz\u0161\u00ED\u0159it l\u00E9\u010Dbu o peror\u00E1ln\u00ED kortikosteroidy a/nebo antibiotika, pokud byla zji\u0161t\u011Bna infekce. \nMiflonid obvykle neovliv\u0148uje funkce k\u016Fry nadledvin, av\u0161ak u mal\u00E9ho po\u010Dtu pacient\u016F byly p\u0159i dlouhodob\u00E9m pod\u00E1v\u00E1n\u00ED doporu\u010Den\u00E9 denn\u00ED d\u00E1vky pozorov\u00E1ny syst\u00E9mov\u00E9 \u00FA\u010Dinky. \nZvl\u00E1\u0161tn\u00ED opat\u0159en\u00ED\nPacienti nez\u00E1visl\u00ED na steroidech\nU t\u011Bchto pacient\u016F je dosa\u017Eeno terapeutick\u00E9ho \u00FA\u010Dinku obvykle b\u011Bhem 10 dn\u016F. U pacient\u016F s\u00A0nadm\u011Brnou muk\u00F3zn\u00ED bronchi\u00E1ln\u00ED sekrec\u00ED je mo\u017En\u00E9 po kr\u00E1tkou dobu (asi 2 t\u00FDdny) p\u0159idat na za\u010D\u00E1tku peror\u00E1ln\u00ED kortikosteroidy.\nPacienti z\u00E1visl\u00ED na steroidech.\nP\u0159i zah\u00E1jen\u00ED p\u0159echodu z\u00A0l\u00E9\u010Dby peror\u00E1ln\u00EDmi steroidy na inhala\u010Dn\u00ED formu budesonidem, by m\u011Blo b\u00FDt onemocn\u011Bn\u00ED pacienta\u00A0relativn\u011B stabilizov\u00E1no. Vysok\u00E1 d\u00E1vka budesonidu se pod\u00E1v\u00E1 po dobu asi 10 dn\u016F v\u00A0kombinaci s\u00A0d\u0159\u00EDve u\u017E\u00EDvan\u00FDm peror\u00E1ln\u00EDm steroidem. Potom by m\u011Bla b\u00FDt peror\u00E1ln\u00ED d\u00E1vka postupn\u011B sni\u017Eov\u00E1na (nap\u0159. o 2,5 mg prednisolonu nebo jeho ekvivalentu ka\u017Ed\u00FD m\u011Bs\u00EDc) a\u017E na nejni\u017E\u0161\u00ED mo\u017Enou l\u00E9\u010Debnou d\u00E1vku. L\u00E9\u010Dba dopl\u0148kov\u00FDmi syst\u00E9mov\u00FDmi kortikosteroidy nebo Miflonidem by nem\u011Bla b\u00FDt ukon\u010Dena n\u00E1hle. \nPo zm\u011Bn\u011B l\u00E9\u010Dby ze syst\u00E9mov\u00FDch kortikosteroid\u016F na budesonid je nutn\u00E9 b\u011Bhem prvn\u00EDch m\u011Bs\u00EDc\u016F l\u00E9\u010Dby pacienta pe\u010Dliv\u011B sledovat, aby bylo zaji\u0161t\u011Bno, \u017Ee adrenokortik\u00E1ln\u00ED rezerva pacienta je natolik dostate\u010Dn\u00E1, \u017Ee je schopn\u00E1 zvl\u00E1dnout i specifick\u00E9 krizov\u00E9 situace, jako je chirurgick\u00FD z\u00E1krok, \u00FAraz nebo z\u00E1va\u017En\u00E9 infekce. V\u00A0t\u011Bchto situac\u00EDch je nutn\u00E9 pravideln\u011B monitorovat funkci HPA (hypothalamo-pituit\u00E1rn\u00ED-adren\u00E1ln\u00ED) osy. N\u011Bkter\u00FDm pacient\u016Fm je za t\u011Bchto okolnost\u00ED nutn\u00E9 dod\u00E1vat nav\u00EDc kortikosteroidy. T\u011Bmto pacient\u016Fm se doporu\u010Duje, aby u sebe nosili karti\u010Dku s\u00A0upozorn\u011Bn\u00EDm na jejich potenci\u00E1ln\u011B nebezpe\u010Dnou zdravotn\u00ED situaci. Substituce syst\u00E9mov\u00FDch kortiksteroid\u016F budesonidem m\u016F\u017Ee odhalit alergie (alergick\u00E1 r\u00FDma, ekz\u00E9m) d\u0159\u00EDve potla\u010Den\u00E9 celkov\u011B pod\u00E1van\u00FDmi kortikosteroidy. Tyto alergie musej\u00ED b\u00FDt l\u00E9\u010Deny antihistaminiky nebo lok\u00E1ln\u011B aplikovan\u00FDmi kortikoidy.\n"@cs . . . . . . "004.004" . . . . . . "4.4 \tZvl\u00E1\u0161tn\u00ED upozorn\u011Bn\u00ED a zvl\u00E1\u0161tn\u00ED opat\u0159en\u00ED pro pou\u017Eit\u00ED"@cs . .