A group of anti-inflammatory drugs used to treat several respiratory disorders
Corticosteroids are drugs that are related to natural hormones. When used to treat respiratory disorders, these drugs reduce or prevent inflammation of the airways. Corticosteroids are frequently prescribed to prevent attacks of asthma. They are also occasionally prescribed for people with chronic obstructive pulmonary disease. In addition, corticosteroids are sometimes helpful in preventing or treating inflammation of the nasal passages in allergic conditions such as hay fever (see Allergic rhinitis).
How do they work?
The lining of the airways in the lungs becomes inflamed in asthma. This reaction causes the airways to narrow and restricts air flow. Corticosteroids reduce inflammation by inhibiting the release of natural chemicals, called prostaglandins, that play a key role in triggering the inflammatory response. Reducing inflammation widens the airways and thereby relieves or prevents asthma attacks. When they are used in treating hay fever, corticosteroids act on the lining of the nose to reduce inflammation. In people with sarcoidosis or fibrosing alveolitis, the reduction in inflammation slows down and minimizes damage to lung tissues.
How are they used?
Your doctor may prescribe an inhaled corticosteroid if you are experiencing attacks of asthma or if you find that you need to use bronchodilator drugs more than a few times a week. Regular use of inhaled corticosteroid drugs can prevent asthma attacks occurring, and, over time, it may be possible to reduce the dose. If you have a severe asthma attack, you may need to take an oral corticosteroid drug for a few days. Long-term use of low-dose oral corticosteroids is usually necessary only if you have severe asthma that cannot be controlled by inhaled drugs. If you are admitted to hospital with a severe attack, you may be given an intravenous corticosteroid. To treat hay fever, corticosteroids are taken as a nasal spray. People who have fibrosing alveolitis or sarcoidosis will probably be prescribed long-term treatment with oral corticosteroids.
If you have been taking oral corticosteroids for more than a few weeks, do not stop taking them suddenly. If the drugs are taken for a prolonged period, they can suppress the body’s own production of corticosteroids, which are needed to fight infection. The dose should be reduced gradually to allow natural corticosteroid production to resume.
If you are prescribed an oral corticosteroid for longer than a few weeks, your doctor or pharmacist will give you a treatment card to carry with you at all times.
What are the side effects?
The side effects from inhaled corticosteroids are usually minimal because the drugs act directly on the airways with little effect elsewhere in the body. The most common side effect is oral thrush (see Candidiasis), a fungal infection more commonly associated with other areas of the body. To avoid this infection, rinse your mouth with cold water after using your inhaler.
Your doctor will prescribe the lowest dose for your condition to reduce the risk of side effects. However, if oral corticosteroids are taken on a long-term basis, there is a risk of side effects, including an increased susceptibility to infections, osteoporosis, cataracts, bruising, glaucoma, and slowed growth in children.
Do not suddenly stop taking oral corticosteroids without first consulting your doctor.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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