When used in high doses, a small amount of the medication is absorbed into the bloodstream and some side effects beyond the mouth and throat may develop. The most likely to be encountered are easy bruisability of the skin and suppression of the adrenal glands. The significance of adrenal gland suppression is discussed in further detail in the pamphlet entitled Asthma and Steroids in Tablet Form , prepared by the Partners Asthma Center. The risk from the long-term use of inhaled steroids in terms of hastening thinning of the bones (osteoporosis) is currently being studied. However, it is widely agreed that any risk that may be discovered will be far less than that resulting from use of steroids in tablet form in doses needed to achieve the same control of asthma.
What are the current recommendations and dosing amount/duration for treating with oral Prednisone in active/chronic childhood and adult asthmatics with exacerbations most likely due to molds (Florida late winter & early spring) . non-productive paroxysmal cough and wheeze not responding to inhaler (Advair type combo and/or inhaled steroid) and anti-histamines and recently treated and/or failure to resolve with Antbx?
In a patient as described above (no relief with inhaled treatments and anti-histamines/Leukotriene inhibitor) what levels can be used for IgE? Total to initiate Oral Steroids, I've seen a local Pulmonologist recommend adding Oral Steroids when the Ige total is above 500. Is there a reference for this? It has worked on our patients we have referred to them and they initiated that treatment type recommendation and protocol. Also they used Ige total greater than 200 for ABPA patients to start treatment.
If asthma symptoms are frequent or unpredictable, your allergist may advise you to take medications on a routine basis. Drugs used for this purpose include inhaled steroids, antileukotrienes, cromolyn and related drugs, inhaled or oral beta agonists (some of which are long acting), long-acting theophyllines, or oral steroids. For allergic patients, immunotherapy (allergy shots) may offer relief from allergens that cannot be avoided. Immunotherapy increases a patient's tolerance to the allergens that prompt asthma symptoms and appears to help control the inflammation that underlies chronic asthma.