Corticosteroids

Corticosteroids are the most powerful and effective anti-inflammatory medications for the treatment of asthma. Because of the importance of controlling airway inflammation and hyper-responsiveness, corticosteroids are considered the primary treatment for moderate persistent to severe persistent asthma.

When used regularly, corticosteroids help:

• Decrease airway inflammation
• Decrease mucus production
• Decrease the allergic process
• Improve peak flows and lung function tests
• Decrease airway hyper-responsiveness or twitchiness
• Prevent acute episodes of asthma
• Increase the effectiveness of other asthma medications

Though they may be the most important medication in your asthma treatment plan, the effects of the corticosteroids are not noticed immediately. Corticosteroids do not cause bronchodilitation (airway opening); in other words, taking this medication will not immediately cause the airways open up. Corticosteroids should be taken on a regular basis for preventative purposes rather than in an emergency or for rescue.

Types of Corticosteroids

There are three ways patients may take corticosteroids:

• Inhaled Corticosteroids - These are a safe and effective treatment for persistent asthma. The inhaled corticosteroid can be used for short- or long-term treatment without the adverse side effects of oral corticosteroids.
• Short Burst of Oral Corticosteroids - Oral Corticosteroids are used to treat a moderate to a severe episode of asthma not coming under adequate control with other asthma medications. The short burst of oral corticosteroids begins to work within 3 hours, but may take up to 12 hours before any significant difference occurs. Frequent "bursting" is a good indication that the treatment plan may need to be reevaluated. Regular asthma medications should be continued as prescribed in the treatment plan.
• Long-term Oral Corticosteroids - Long-term Oral Corticosteroids are used only for the severe asthmatic who has not been well controlled with a combination of other asthma medications. When these are necessary, alternate day usage reduces the potential for systemic side effects.

Side Effects of Corticosteroids

Short Burst of Oral Corticosteroids side effects may include an increased appetite, a sense of well being, fluid retention, a slight weight gain, and/or acne. Moodiness may be experienced when the corticosteroid is stopped, but will disappear. Mild body aches may be present and can usually be controlled by taking acetaminophen. If stomach upset occurs, take the corticosteroid with some food.

Long-term Oral Corticosteroids may suppress your body's adrenal function that helps you respond to severe physical stress, such as major injury or surgery. The safest way of taking long-term oral corticosteroids is on an alternate, every-other-day basis. They should be taken in the morning to match the peak of the corticosteroids produced within our own bodies. If corticosteroids are necessary, your doctor's goal should be to prescribe them in the safest way, and in the least amount possible.