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Cystic Fibrosis Treatment Side Effects

Introduction

As valuable as general measures are to treat cystic fibrosis, I would be remiss not to talk about side effects of treatment for cystic fibrosis.  Apart from treating CF it is also important for the patient and the family to know that there are possible side-effects with CF treatment. The chronic lung condition is being treated for a long time, so, if corticosteroids are used for this the side-effects of this treatment can lead to stunted growth in children and to a tipping of the metabolic balance in the direction of diabetes (hyperglycemic effect). Rarely corticosteroid use (particularly in higher doses) can cause hip fractures because of osteonecrosis of the ball of the hip joint. Antibiotics can have serious side effects as well. For instance, Tetracycline in the first years of life can cause malformation and permanent staining of teeth. Chloramphenicol for the more difficult to treat bacteria can on the longterm cause blindness and loss of feeling (optic atrophy and polyneuropathy).

Aminoglycosides, another group of antibiotics, can cause hearing loss and balance problems as well as kidney damage. Chronic use of mucous loosening iodine containing expectorants can cause goiter (a benign thyroid tumor). Spironolactone, a water pill that is used for water retention from right sided heart failure and for pulmonary hypertension, can cause breast development (gynecomastia) , which is embarrassing in children, particularly in boys, and requires surgical removal in boys. High-dose pancreatic enzymes that are used to improve digestion can cause small bowel obstruction, colonic stricture (leading to large bowel obstruction) and to high uric acid levels, which can precipitate a gout attack. Over-treating diabetes with insulin can lead to life threatening hypoglycemia. These are only some of the most common side effects with regard to various treatment modalities used in treating CF. Your doctor can give you information about other side effects of treatments that are being used. Support groups for CF and participation in educational sessions is very advisable for patients and loved ones around the CF patient.

 Cystic Fibrosis Treatment Side Effects (Gynecomastia)

Cystic Fibrosis Treatment Side Effects (Gynecomastia)

 

References:

1. Noble: Textbook of Primary Care Medicine, 3rd ed., Copyright © 2001 Mosby, Inc.

2. National Asthma Education and Prevention Program. Expert Panel Report II. National Heart, Lung and Blood Institute, 1997.

3. Rakel: Conn’s Current Therapy 2002, 54th ed., Copyright © 2002 W. B. Saunders Company

4. Murray & Nadel: Textbook of Respiratory Medicine, 3rd ed., Copyright © 2000 W. B. Saunders Company

5. Behrman: Nelson Textbook of Pediatrics, 16th ed., Copyright © 2000 W. B. Saunders Company

6. Merck Manual: Cystic fibrosis (thanks to www.merckmanuals.com for this link)

7. Goldman: Cecil Textbook of Medicine, 21st ed., Copyright © 2000 W. B. Saunders Company

8. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

9. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

Last modified: November 10, 2014

Disclaimer
This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.