Steroids in Asthma: Why We Need Them?

Why do we use steroids in asthma?

* Inflammation of the airways is the underlying problem in asthma

* Steroids like Prednisone and Decadron are taken by mouth

* Steroids like betamethasone and fluticasone are inhaled like albuterol.

* Steroids are used to control inflammation in asthma

* Lung inflammation in moderate asthma can be controlled but not cured.

The basic problem in asthma lungs is inflammation.

Inflammation means swelling, oozing, and fragility of the breathing tube linings.  

Extra mucus is produced from this inflammation and together with the swelling, creates a lot of extra resistance to air flow.  

When these breathing tubes are fired up with swelling and mucus, the effort to move air, especially out of the lungs, can be exhausting.

All of my work as your doctor is aimed at keeping a lid on this inflammation.  The tendency for it to get out of control will always be there – that’s the way asthma is.

But, with the right medication and avoidance of triggers, you can stay out of the ER, get restful sleep, and be as active as an Olympic athlete!

Now, when the inflammation is out of control, we have only one choice.

SHUT IT DOWN.

The most potent and fast acting medicine we have for this is corticosteroids.  

We say steroids for short.  

This isn’t the steroids injected by weight lifters to make big muscles – those are called anabolic steroids..  

Corticosteroids work inside the cells of the breathing tube walls to block the inflammation process.

They work – but their action is not immediate.

Prednisone and Dexamethasone are the most common forms used in non-hospitalized asthma patients.

These steroids are taken by mouth, or if your breathing is really bad, they are given intravenously.

Either medicine must be taken for 3-5 days straight for the full effect.

After these medicines shut down the inflammation process in the breathing tubes, we are in a position to launch a new asthma action plan that includes stronger controller medicine in the form of inhaled steroids, also called controllers.

These inhaled corticosteroids have dramatically changed the course of asthma.  

Lives have been saved and many days of disrupted sleep, work, & school have been prevented. 

For more severe asthma sufferers, there are new medications – biologics, that are likely to make even more dramatic improvements in severe asthma control.    

For most moderate asthma patients, inhaled corticosteroids will be a cornerstone of their asthma action plan.

Finding the right type of steroid compound, the frequency that works, and the one that you and your insurance company accept is a really important part of asthma care.

If you are using your albuterol rescue inhaler daily and aren’t using a steroid inhaler, you need one.  

If you are using your albuterol rescue inhaler more than two times per week and you ARE on a steroid inhaler, you need a change that delivers more steroid either per dose or more times per day.

Thanks for learning more about asthma!

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