An 8-year-old boy w ith m ild persistent asthm a was in the chest clinic for follow-up of his…

An 8-year-old boy w ith m ild persistent asthm a was in the chest clinic for follow-up of his disease. He had been only m oderately well controlled on inhaled albuterol “as needed.” Physical exam ination showed di use expiratory w heezes, and pulm onary function testing revealed a peak expiratory ow rate 60% of predicted. The physician decided to add inhaled beclom ethasone to the therapy, but the boy’s m other was concerned about the adverse e ects of glucocorticoids. The physician told the m other that system ic adverse e ects of inhaled beclom ethasone are extrem ely rare. Which of the follow ing statem ents best explains the reason for this low toxicity? A. The drug is com pletely m etabolized by the lung. B. The drug is quickly elim inated by the kidney. C. The dose reaching the system ic circulation is very sm all. D. The drug is com pletely elim inated w ith the exhaled air. E. Beclom ethasone is the least toxic of glucocorticoid drugs.

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