Anti-inflammatory agents
People with asthma have inflamed airways. This inflammation causes the bronchi—the main branches leading from the throat to the lungs—to become overly reactive. The airways are more sensitive to various asthma triggers such as allergens, cold and dry air, smoke and viruses. Anti-inflammatory agents such as
cromolyn ,
nedocromil and
corticosteroids reduce inflammation and asthma symptoms. Cromolyn and nedocromil are non-steroidal and usually are prescribed in the inhaled form, while corticosteroids are prescribed in both the inhaled (topical) and oral form.
Corticosteroids are sometimes also referred to as " steroids." This type of medication is not related to the anabolic steroids that are misused by some athletes to increase performance. Rather, corticosteroids have been used as a successful treatment for asthma and allergies since 1948. They decrease airway inflammation and swelling in the bronchial tubes; reduce mucus production by the cells lining the bronchial tubes; decrease the chain of overreaction (hyperreactivity) in the airways; and help the airway "smooth muscle" respond to other medications.
Corticosteroids can be administered in a variety of ways. Topical preparations (on specific surface areas such as skin or the lining of the bronchial tubes) may be applied as creams or sprays (inhalers). Corticosteroid inhalers are recommended for patients with daily, moderate or severe asthma symptoms. Oral corticosteroids may be ingested in a liquid or tablet form, or may be administered by injection. They are generally only prescribed for those with severe asthma symptoms.
Some people may experience minor side effects of hoarseness and thrush (a fungal infection of the mouth and throat) from using corticosteroid inhalers. Such problems can be minimized by mouth-rinsing and using a spacer device, which can reduce the amount of medication residue in the mouth and throat. Although there are conflicting studies, long-term use of inhaled corticosteroids may result in reduced growth velocity in children. However, control of asthma symptoms may be of greater importance. If you are concerned about your child using these medications on a long-term basis, see your physician for more information.
Oral corticosteroids can have more side effects than inhaled corticosteroids. Long-term use of oral corticosteroids is not recommended, except in cases of uncontrolled, severe asthma. Your doctor will prescribe oral steroids for long durations only when other treatments have failed to restore normal lung function and the risks of uncontrolled asthma are greater than the side effects of the steroids. Prednisone, one of the most commonly prescribed steroid drugs, is available in tablet or liquid form. Possible side effects of short-term prednisone use include slight weight gain, increased appetite, menstrual irregularities and cramps, heartburn, or indigestion. Some patients experience side effects such as loss of energy, poor appetite, and severe muscle aches or joint pains when their dosage of cortisone tablets is decreased. If you are taking oral steroids, your physician will taper your dosage slowly for weeks or months to avoid effects of withdrawal.
Long-term oral corticosteroid use may cause side effects such as ulcers, weight gain, cataracts, weakened bones and skin, high blood pressure, elevated blood sugar, easy bruising and decreased growth in children. If you have questions or concerns about long-term oral steroid use, make sure to discuss them with your physician.
Corticosteroids, when taken properly, are a very effective method of treatment for asthma and allergies. To achieve their desired effects, you should always take them in the dosage prescribed. Do not increase or decrease your medication without first consulting your physician. Also, it is important to follow the prescribed frequency and use the proper inhaler technique to administer the medication. Please see the Tip brochure in this series for more information on the use of inhaled medications for asthma.
