Asthma Medicines

Oral and IV Corticosteroids
Even people whose asthma is usually well controlled with their regular medicines might end up with a serious asthma attack in certain situations (for example, after a bad cold, or if exposed to a potent allergen). In these cases, inflammation is dramatically increased, and potent, quick-acting medicine is needed to bring down the swelling.

Oral and intravenous corticosteroids, also known as "systemic steroids" (see glossary entry for steroids) are medicines used in an urgent situation, when asthma is out of control. They act fast to reduce swelling in the airways and get symptoms back under control. Inhaled steroids, the medicines usually used to reduce airway swelling in asthma, can take several weeks to work. Oral and IV steroids, on the other hand, begin to work in about 12 hours.

Common names of oral corticosteroids are prednisone and prednisolone. These are taken by mouth either as a pill or a liquid. Intravenous (IV) corticosteroids, such as Solu-Medrol, are given in the emergency room or hospital through a vein in your arm or hand.

Although systemic steroids are usually the best way to get serious airway inflammation under control quickly, they are not good medicines to use for long-term control. Because oral and IV steroids go all throughout the body, they have many more side-effects than inhaled steroids (which go right to the lungs, where they are needed).

Possible side-effects from taking systemic corticosteroids short-term (for a week or two) include skin rashes, weight gain, insomnia, and mood changes. Steroids can also affect metabolism of carbohydrates, sometimes leading to higher blood sugar.

Side effects from taking systemic corticosteroids long-term can include fat re-distribution over the body, weakening of bones, poor wound healing, and in children, stunting of growth.

Since inhaled corticosteroids do not have these side effects (or at high doses, may have them only to a small degree), they are preferred over systemic steroids for long-term control of airway inflammation.

Remember that both inhaled corticosteroids and systemic corticosteroids are entirely different from the anabolic steroids that some athletes use to increase muscle mass!