Long-Term (Maintenance) Medications

Corticosteroids –  Medications found to be the most effective are those that have an anti-inflammatory effect.  Inhaled corticosteroids are the most commonly used anti-inflammatory medications.  These medicines are based on a hormone your body produces naturally…they are NOT related to the anabolic steroids that are sometimes misused by athletes to increase muscle mass. Corticosteroids are very effective in routine asthma control and maintenance because they provide treatment for inflammation.  Oral steroids are used along with your inhaled (rescue) bronchodilator medicine to relieve an asthma attack.  The corticosteroids can reduce the airway inflammation that can cause symptoms.

Oral Corticosteroids

Corticosteroids, such as prednisone, prednisolone, Medrol, and Decadron are usually used for acute asthma.  Steroids are the most potent anti-inflammatory medications.  They decrease inflammation and mucous production, decrease twitchiness of the airways, and increase the effectiveness of other asthma medications.

Steroids usually are given in a burst and then may or may not be tapered over the next week or two.  Steroids begin to work in 4 to 6 hours, reach maximum effectiveness in 12 hours, and last for 30 to 36 hours.

Side effects of steroids are very minimal when used for short periods (less than two weeks).  They may cause an increase in appetite, feeling of well being, fluid retention, weight gain, and occasionally flushing.  Moodiness may occur during therapy or when the steroid is stopped.  Taking the steroid with food can usually reduce upset stomach, which may occur when taking steroids.

Oral steroids that are used for longer periods (months to years) may produce:  diabetes, high blood pressure, obesity, brittle bones, glaucoma, cataracts, and other side effects.  However, if oral steroids are required for your breathing, they must be taken and side effects will be monitored.

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