The aim of this article is to bring less well recognised adverse effects of inhaled corticosteroids to the attention of prescribers. Whilst inhaled steroids have a more favourable side effect profile than systemic steroids, they are not free from adverse effects. The dose of inhaled steroids used should be carefully monitored, and kept at the lowest dose necessary to maintain adequate control of the patient’s disease process. Be particularly aware of the cumulative effect of co-prescribing various dose forms of corticosteroids (inhaled, intranasal, oral and topical preparations).
Oral and injectable systemic corticosterois are steroid hormones prescribed to decrease inflammation in diseases and conditions such as arthritis (rheumatoid arthritis, for example), ulcerative colitis, Crohn's disease, asthma, bronchitis, some skin rashes, and allergic or inflammatory conditions that involve the nose and eyes. Examples of systemic corticosteroids include hydrocortisone (Cortef), cortisone, prednisone (Prednisone Intensol), prednisolone (Orapred, Prelone), and methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol). Some of the side effects of systemic corticosteroids are swelling of the legs, hypertension, headache, easy bruising, facial hair growth, diabetes, cataracts, and puffiness of the face.
To reduce swelling and tightness in their airways, some children with asthma are treated for months or years with an oral corticosteroid, such as prednisone. Others may be treated with a short “burst” of an oral corticosteroid for five to seven days. A burst is prescribed in an emergency situation when asthma severity markedly intensifies. While corticosteroids are known to suppress immune function, children receiving oral corticosteroid treatment rarely have complications from chickenpox.
There is no evidence that an inhaled corticosteroid poses an increased risk for children with asthma who are exposed to chickenpox. Inhaled corticosteroids are used for long-term relief of symptoms and reduce the need for extra medicine, such as oral steroids.