Corticosteroids for respiratory disease
Corticosteroids for respiratory disease are 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).
Less commonly, corticosteroids are used to treat people with sarcoidosis and fibrosing alveolitis, disorders in which the tissues of the lungs become inflamed.
How do corticosteroids 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 blocking the action of certain natural chemicals in the body, called prostaglandins, that are normally responsible for triggering the inflammatory response. Reducing inflammation widens the airways and thereby relieves or prevents asthma attacks. When they are used in treating hay fever, corticosteroid drugs act on the lining of the nose to reduce inflammation. In people with sarcoidosis or fibrosing alveolitis, the reduction in inflammation produced by corticosteroid treatment slows down and minimizes damage to lung tissues.
How are corticosteroids 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 corticosteroid drugs for more than a few weeks, it is important not to stop taking them suddenly. If these drugs are taken for a prolonged period of time, they can suppress the body's own production of corticosteroids, which are needed to fight infection. The dose should therefore be reduced gradually in order to allow the body to restore normal levels of corticosteroid production.
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 in case of an emergency.
What are the side effects corticosteroids?
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.
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