Inhaled steroids
Some parents are really hesitant about using the controller medicines, the inhaled steroids, because they have the word “steroids” in their name. I make sure that parents understand that these inhaled cortical steroids are different than the steroids they hear about on the news, that they are not the same steroids that some athletes abuse and that they don’t do the same kinds of things or have the same kinds of side effects. Parents often worry that if their child takes steroids every day that the steroids will build up over time. There is some absorption you get of the inhaled steroids into your body, but the amount is much less than is absorbed during a five or six day course of oral steroids which are used during asthma attacks. In other words, if a child has two bad asthma attacks over the course of a year and they need to come into the hospital and take the oral steroids for several days each time, the amount of steroids absorbed during those two asthma attacks is more than the kid would get using inhaled controller steroids every single day for a year. I explain to parents that these steroids have been studied and there are no significant side effects from using inhaled steroids on a daily basis. So I try to point out that it’s a risk/benefit thing: there are very few risks and a lot of benefits.
Shari Nethersole, MD, Pediatrician
“What is this controller medication steroid business?”
Parents all have concerns about medications: “What is this controller medication steroid business?” We hear a lot of that, and so we spend a lot of time overcoming the myths associated with inhaled steroid use. We make sure parents know that the inhaled steroids we use to treat asthma aren’t the “roids” that the athletes use, and that their kids won’t build muscle, bulk up or have the other dangerous side effects associated with anabolic steroids.
Amy Burack, RN, MA, AE C, Former Community Asthma Programs Manager
How spacers deliver asthma medicine
I think people are surprised to learn that everyone needs a spacer with their inhaler. They don’t realize when the medicine gets squirted through an inhaler it comes out at about 65 miles per hour. Nobody can coordinate squirting and breathing in at that speed– we don’t inhale at 65 miles per hour! By squirting the medicine into the spacer, though, inhaling can be much more controlled and more of the medication can make it into a person’s lungs, instead of getting deposited in the backs of their throats. This also decreases the chances of getting a hoarse voice or thrush. Thrush is a fungal infection of the mouth and can be a side effect of inhaled steroids.
Beth Klements, MS, APRN, BC, Asthma Clinical Nurse Specialist, Pediatric Nurse Practitioner
How nebulizers deliver asthma medicine
Nebulizers are a passive way to deliver medicine, and are usually easier to use than an inhaler or an inhaler and a spacer. The asthma medication goes in a compartment, and then you attach the tubing to it and it attach it to a compressor. When you turn the compressor on, put on a mask, and the medication will come out like steam or a mist and you just breathe it the medicine until it’s gone – it usually takes between five and ten minutes. Nebulizers are really helpful during acute asthma attacks when the lungs are really tight. During those times, it is difficult for inhalers to work because the lungs are too tight for the medicine to get in and open them up. The mist from the nebulizers, though, works gradually, little by little, so they help to get into the lungs to dilate them and open them up more and more.
Beth Klements, MS, APRN, BC, Asthma Clinical Nurse Specialist, Pediatric Nurse Practitioner