Side Effects Of Inhaled Steroids

The rationale behind introducing inhaled aerosol steroids was to reduce the side effects seen with systemic therapy. According to the Cleveland Clinic, inhaled corticosteroids have few side effects, especially at lower doses. Although aerosol steroids are administered in lower doses because of their direct effect in the lung, side effects may still occur, particularly when switching from oral to inhaled steroids. If a patient is currently receiving oral corticosteroids and has been prescribed inhaled steroids to replace them, tapering the dose of the oral medication should be done to give the body time to recover from the body's own adrenal secretion.

Allergic Inflammation

Transitioning from oral to inhaled steroids may cause an allergic response such as inflammation, nasal polyps or dermatitis during the process of beginning inhaled steroids and tapering off oral steroids. According to the Cleveland Clinic, inhaled steroids prevent the inflammatory response often experienced in asthma and other pulmonary diseases. Temporary side effects during the transition can far outweight the benefits of fewer asthma attacks and enhanced lung function.

Thrush

A common side effect of inhaled steroids is thrush, an infection in the mouth. According to the Cleveland Clinic, a thrush outbreak is rare, but the yeast infections that characterize thrush, along with a hoarse voice, can result from high doses of inhaled steroids. Rinsing out the mouth after each use will reduce the chances of getting thrush. Using a spacer can also help. A spacer is a device that attaches to a metered dose inhaler, making it easier to inhale the medication directly into the lungs. limiting the amount of medication that sprays into the mouth.

Acute Asthma

Acute asthma flare-ups may occur as oral steroids are tapered off and the patient transitions to inhaled steroids. Until the correct dose is achieved, aerosolized steroids may not be sufficient to control sudden flare-ups, particularly when a patient is under more stress than usual, or exposed to allergens or triggers. Short-term use of oral steroids may be necessary to get symptoms in check. This treatment is called "burst" therapy.

Hypothalmic-Pituitary-Adrenal

A simplified explanation of the hypothalmic-pituitary-adrenal, or HPA, response is that the body naturally produces and limits its production of glucocorticoids. As the body cannot distinguish between its own glucocorticoids and those taken orally, administering these drugs raises the body's level of these hormones, which in turn decreases production; this is called HPA suppression. According to a study reported in the September 2003 issue of "The Journal of Allergy and Clinical Immunology," HPA suppression is often the result of taking oral corticosteroids, and occurs to a lesser extent when taking inhaled steroids. One of the primary reasons for using inhaled glucocorticoids is to minimize HPA suppression by minimizing the dosage. This process relates to the metabolism of carbohydrates, fats and proteins.