Nebulisers are machines that turn the liquid form of your short-acting bronchodilator medicines into a fine mist, like an aerosol. You breathe this in with a face mask or a mouthpiece. Nebulisers are no more effective than normal inhalers. However, they are extremely useful in people who are very tired (fatigued) with their breathing, or in people who are very breathless. Nebulisers are used mainly in hospital for severe attacks of asthma when large doses of inhaled medicines are needed. They are used less commonly than in the past, as modern spacer devices are usually just as good as nebulisers for giving large doses of inhaled medicines. You do not need any co-ordination to use a nebuliser - you just breathe in and out, and you will breathe in the medicine.
Although it is well-established that psychiatric symptoms can develop in association with the administration of corticosteroids, the nature of this relationship is poorly understood. We reviewed 14 previously unreported cases of steroid-induced psychiatric syndromes, 79 cases from the literature and 29 studies of the clinical efficacy of steroids in various medical illnesses. Our findings indicate that severe psychiatric reactions occur in approximately 5% of steroid-treated patients, and that a large proportion of these patients have affective and/or psychotic symptoms. Psychiatric disturbances usually occur early in the course of steroid therapy. Female sex, systemic lupus erythematosus and high doses of prednisone may be risk factors for the development of a steroid-induced psychiatric syndrome. Treatment with steroid-taper, neuroleptics or electroconvulsive therapy is generally effective, although tricyclic antidepressants do not appear to be useful therapeutic agents. Most patients recover within several weeks of the onset of symptoms.
Again, as with estrone, results with testosterone propionate were not always so positive. In 1939, the Council of Pharmacy and Chemistry of the American Medical Association refused to accept testosterone for New and Nonofficial Remedies stating, ‘the involutional melancholia of males, for which testosterone has been suggested, has not been subjected to adequate trials, to justify androgenic therapy other than on an experimental basis.’ No ‘noticeable improvement’ in mental condition was found in 5 cases of male involutional melancholia who were treated with intramuscular injections of testosterone propionate 10mg 3 times weekly for a period of 3 to 4 weeks by Barahal (1938). Barahal (1940) also found little or no change in the mental condition of 7 psychotic male homosexual patients who were treated with intramuscular injection of testosterone propionate (25mg) 3 times weekly for 18 months. In addition, Pardoll and Belinson (1941) reported that mental improvement was not sufficiently pronounced to warrant administering testosterone propionate as routine treatment for the male involutional psychoses after treating 11 males with 10mg doses of testosterone propionate twice weekly for 3 months and observing behaviour for 2 months following cessation of therapy.