Corticosteroids (Oral)

Asthma is an inflammatory disease and since oral steroids are the most effective anti-inflammatory agent, they are particularly effective in the treatment of asthma. Despite their effectiveness, oral corticosteroids carry the risk of side effects if taken long term. They should only be used in acute exacerbations and for those who have failed inhaled steroids. In general, for acute asthma, the benefit of corticosteroids far outweigh the potential risks and can be life saving.

Brand Names

  • Decadron
  • Deltasone
  • Dexamethasone
  • Liquid Pred
  • Medrol
  • Orasone
  • Pediapred
  • Prednisolone
  • Prednisone
  • Prelone

Drug Action

Corticosteroids decrease inflammation in the airways. This effect may begin within hours and is secondary to a decrease in the inflammatory cells in the airways.

Potential Side Effects

  • Increased appetite/weight gain
  • Cataracts
  • Osteoporosis (weakening of the bones); can cause growth retardation in children
  • Fullness of the face (moonface)
  • Elevated blood pressure
  • Muscle weakness
  • Changes in fat distribution
  • Skin changes such as acne
  • Bruising more easily
  • Salt and fluid retention
  • Less resistance to infection
  • Diabetes mellitus
  • Suppression of normal corticosteroid production
  • Menstrual disorders
  • Severe chicken pox reaction

If the individual has not had the chicken pox, and are exposed to them while taking oral corticosteroids, they need to notify their physician immediately. The physician may want to alter the steroid dose to prevent severe infection from developing.

Available Forms

Liquids can be mixed with something sweet to be better tolerated; their action becomes effective in 4 to 6 hours. Tablets are also effective for 4 to 6 hours. Intravenous injections can be given in the hospital setting.

Additional Comments

  • Oral corticosteroids should be taken as directed by your physician. There is some evidence that 3PM dosing may be the most effective.
  • Oral corticosteroids may be used in early treatment of acute asthma exacerbations to prevent severity of attack.
  • Corticosteroid doses need to be increased at times of increased physical stress such as surgery. If presently utilizing or if taken regularly within six months of surgery, additional corticosteroids will be needed at the time of surgery, to prevent potential complications. A calcium supplement may be necessary when on long-term oral corticosteroids.
  • The dose of oral corticosteroids should be decreased gradually by those taking corticosteroids for a prolonged time because the adrenal glands (glands responsible the making the body’s natural corticosteroids) take time to resume their production.
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