COMBATTING ASTHMA IN CHILDREN: ANTI-INFLAMMATORY DRUGS – STEROIDS: THE CORTISONE DRUGS – SIDE EFFECTS OF STEROID TREATMENT

The side effects which may arise with steroid treatment depend on the level of the dose and the duration for which it is taken. Major side effects take months to develop. Steroid treatment for a few days, or a few weeks, is safe and rarely causes problems. However, if steroids are used regularly several times a day, the chances of developing side effects increase. Many of the unacceptable side effects of cortisone can be avoided by giving the drug once a day in the morning, or on alternate days. Alternate-day steroid therapy has become a well-accepted method for treating asthma which does not respond to the conventional drugs. It has allowed many severe asthmatics to stay out of hospital and lead a relatively normal life. Prednisone or prednisolone is the cortisone drug of choice in alternate day therapy. However, sometimes children may develop the following fairly serious side effects after long-term use of oral steroids in higher doses.
1. Changes in shape of the body. Steroids often stimulate appetite, therefore weight gain is a common side effect. Steroids can also change the normal distribution of body fat, shifting it to the face and trunk, so that a round-faced, round-bodied look develops. This effect can be reversed when the drug is reduced or stopped.
2. Reduced growth rate. Prolonged use of steroids can interfere with the growth rate of the long bones of the body and this can affect the growth of a child. However, even after long periods of suppression by steroids, growth usually resumes when steroids are reduced or stopped.
3. Adrenal suppression. The adrenal glands are the body’s natural source of Cortisol. When cortisol-like drugs are given for extended periods of time, the adrenals may become ‘lazy’ and stop their own production of Cortisol. If the drug is discontinued abruptly after a long period of time, it takes time for the adrenals to begin to function again. During this interim period, the natural supply of corticosteroids is very low. This problem can be avoided by taking gradually decreasing doses. This gives the adrenal glands time to renew their production of Cortisol.
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COMBATTING ASTHMA IN CHILDREN: ANTI-INFLAMMATORY DRUGS – STEROIDS: THE CORTISONE DRUGS – SIDE EFFECTS OF STEROID TREATMENTThe side effects which may arise with steroid treatment depend on the level of the dose and the duration for which it is taken. Major side effects take months to develop. Steroid treatment for a few days, or a few weeks, is safe and rarely causes problems. However, if steroids are used regularly several times a day, the chances of developing side effects increase. Many of the unacceptable side effects of cortisone can be avoided by giving the drug once a day in the morning, or on alternate days. Alternate-day steroid therapy has become a well-accepted method for treating asthma which does not respond to the conventional drugs. It has allowed many severe asthmatics to stay out of hospital and lead a relatively normal life. Prednisone or prednisolone is the cortisone drug of choice in alternate day therapy. However, sometimes children may develop the following fairly serious side effects after long-term use of oral steroids in higher doses.1. Changes in shape of the body. Steroids often stimulate appetite, therefore weight gain is a common side effect. Steroids can also change the normal distribution of body fat, shifting it to the face and trunk, so that a round-faced, round-bodied look develops. This effect can be reversed when the drug is reduced or stopped.2. Reduced growth rate. Prolonged use of steroids can interfere with the growth rate of the long bones of the body and this can affect the growth of a child. However, even after long periods of suppression by steroids, growth usually resumes when steroids are reduced or stopped.3. Adrenal suppression. The adrenal glands are the body’s natural source of Cortisol. When cortisol-like drugs are given for extended periods of time, the adrenals may become ‘lazy’ and stop their own production of Cortisol. If the drug is discontinued abruptly after a long period of time, it takes time for the adrenals to begin to function again. During this interim period, the natural supply of corticosteroids is very low. This problem can be avoided by taking gradually decreasing doses. This gives the adrenal glands time to renew their production of Cortisol.*61\260\8*

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