Asthma Treatment: Steroids and Other Anti-Inflammatory DrugsInhaled corticosteroids ICS have been the mainstay of asthma treatment for over 30 years. The steroid molecules have improved considerably over time, with greater topical potency and less systemic side effects. During that time, numerous studies have shown that ICS are effective at reducing symptoms, exacerbations, hospitalizations, and death due to asthma. Likewise, there have been numerous studies inhaled steroids vs oral the side effects of these medications which have shown that in low to medium doses, there are few if any systemic complications. In the highest doses, there may be a slight increase inhaled steroids vs oral cataracts and loss of calcium from the bone.
Long Term Inhaled Steroids vs Intermittent Oral Steroids | Allergy, Asthma & Sinus Center
Inhaled corticosteroids ICS have been the mainstay of asthma treatment for over 30 years. The steroid molecules have improved considerably over time, with greater topical potency and less systemic side effects.
During that time, numerous studies have shown that ICS are effective at reducing symptoms, exacerbations, hospitalizations, and death due to asthma. Likewise, there have been numerous studies examining the side effects of these medications which have shown that in low to medium doses, there are few if any systemic complications. In the highest doses, there may be a slight increase in cataracts and loss of calcium from the bone.
But, and this is a very important point, these risks have to be weighed against the risks of the alternative: Doctors call this bioavailability. When you use an ICS, you swallow a significant amount of the drug. When the swallowed portion is absorbed in the stomach, it travels directly to the liver where it is broken down and inactivated.
This is called first pass metabolism. This part is not immediately inactivated by the liver and, therefore, is the portion which can lead to systemic side effects. So, back to the math: To be completely honest, the newer inhaled steroids are more potent than prednisone on a mcg-per-mcg basis which means the , day number is inflated.
Also, the amount of steroid that is absorbed and the subsequent systemic side effects vary based on delivery device, inhaler technique, and timing of administration. Nevertheless, the underlying point holds true: Given this and the quality of life improvements afforded by regular inhaled steroids, in all but the mildest asthmatics the tradeoff is a no-brainer.
I am a 75 yr old male in good health-no significant health issues- except ongoing allergies. Skin tests and countless exams have not revealed reason for my allergic reactions. These include congestion, sneezing, mucous…just overall lousy feelings. My sleep is often interupted 5x a night. I do take meds for enlarged prostate in an effort to control my problem. Not only did this med help my shoulder pain but my allergy and urination problems totally stopped for 8 days as this is written.
I previously had taken some of the steriodal sprays which stopped the allergy but aggravated the urination problem. As an occasional, short-term treatment they are ok to use for severe symptoms, but long term use will certainly cause complications.
They are not a long-term answer. Decongestant pills can cause urinary frequency as do some older antihistamines. In my experience, allergy blood tests are a better option for your age group, though statistically, they are likely to be negative in a 75 year-old. Nevertheless, it is still important to rule out allergies and some other potential causes as well. The long term inhaled steroid is more addictive compared to the other one.
The user will be dependent with the drug as time pass by. Although she would be getting the same or more amount of steriod in her system from the oral, would it have any effect on her growth velocity with it being a short term dose?
Really depends on the dose and duration, but, generally, isolated usage of short term oral steroids will not affect growth velocity. Isolated is the key word here. The short answer is very little. At high doses, long term use of older inhaled steroids has been associated with cataracts.
In emphysema patients, high dose ICS led to a slight increased risk of pneumonmia. However, the benefits of these medications generally outweigh the risks. You also have to consider the quality of life improvements and the risk of not taking the medications.
Within a week after I had stopped, I experienced no adverse reaction other than I noticed considerable amount of facial acne and my sex drive shot up a little. This was going on for about a month, then it seemed to settle down back to normal. About 2 months after that, I noticed my hair had thinned out on top.
Believe me, there is a systemic effect with ICS. Quick question — is 9 months on Advair considered long term or short term? You describe side effects of anabolic steroids, like testosterone. They are totally different from the glucocorticoids found in many asthma inhalers. Inhaled corticosteroids have never been associated with acne, libido, or hair loss. As a Respiratory Therapist and Asthma educator I greatly appreciate how you have broke this down.
Daily I talk to parents and educate them the importance of daily inhalers vs oral steroids every months. I had my own break down to it but yours is very clear cut and takes into account the first pass. I have referred a couple parents here already to read your article. My son is 3 years old. He has not been officially diagnosed with Asthma as the symptoms only hit him when he gets a virus.
They conclude it to be viral or intermittent as he has no allergies that we can detect. My doctor is talking about putting him on an inhaled steroid through the sick months.
Is this beneficial for his little growing body? I just want what is best with the least effects on his growth and well being. The simple answer is: Can you take inhaled steroids at the same time that your taking oral steroids,prednisone, 20mg. All steroids have essentially the same potential for side effects. What makes the difference is dose and route of administration. Oral steroids have much greater side effects than inhaled steroids for reasons I outlined in my post.