Prednisolone For Asthma

Written By:

Jannice A. Britanico, M.D, DPPS, DPAPP







Fast Fact: The steroids in steroid tablets or syrup to treat asthma are called corticosteroids. These are a natural copy of steroids the body produces to deal with inflammation or injury. They are dissimilar to the steroids bodybuilders use.

Acute asthma is one of the leading causes of hospital admission and emergency department presentation worldwide. Strategies to lessen the load of symptoms related to acute asthma and cut health resource use are needed. There is high-level evidence that oral corticosteroids are effective in treating acute asthma in children of school age when administered after a doctor has assessed the child.

Many of the benefits of oral corticosteroids have been shown to start within three hours of administration, and delayed dosing is less effective at resolving acute asthma. Incorporating parent initiation of oral corticosteroids into the action and education plans for acute asthma that doctors provide families may be an effective way to ensure oral corticosteroid therapy is initiated promptly when a child suffers an acute asthma episode. However, a strategy of parent-initiated oral corticosteroids is likely to result in higher levels of administration of corticosteroids to children with asthma.


How Prednisolone Can Help Your Asthma

Steroid syrups (specifically, Prednisolone) stop inflammation in your child's airways from worsening, reduce their asthma symptoms, and lower their risk of a life-threatening asthma attack.

If you struggle to control your child's symptoms or have had an asthma attack, treating the inflammation in their airways with steroids is vital. If the inflammation is left untreated, your child is more at risk of symptoms persisting to get more or worse asthma attacks.

Even if your child has been prescribed steroid syrups, they will still need to take all the other medicines they have been prescribed and continue using their preventer inhaler.


When Is Your Child Likely To Need Prednisolone?

Children are most likely to be prescribed Prednisolone if they have an asthma attack or a flare-up of their symptoms. This should be a short course to deal with symptoms, and once they have finished the course, your child's doctor will advise you on how to stop taking them safely.

However, sometimes steroid syrups are prescribed long-term. This is more likely if:

  • the asthma is uncontrolled with the maximum doses of an add-on treatment or preventer inhaler;
  • Your child is waiting to be considered for alternative severe asthma treatments; and
  • their symptoms worsen every time they go off a short course of steroid syrups.


Stopping Steroid Syrup Safely

Most individuals on a short course of steroids can safely cease at the end of their course. However, anyone taking long-term steroids will be told to period. Your body may not produce enough natural corticosteroids, which can induce a condition known as adrenal suppression, a.k.a. adrenal insufficiency.


Adrenal suppression can cause symptoms such as weight loss and fatigue. It is a rare but severe complication of being on long-term steroids.

If your child has been on steroid medicine for a long time and is stopping steroid treatment, their doctor may monitor them and consider blood tests to check their cortisol levels. Their doctor may sometimes prescribe hydrocortisone syrups to support their body as your child's corticosteroid levels drop and they stop taking steroids. Hydrocortisone syrups contain a particular type of steroid to the glucocorticoid steroids in Prednisolone. They sometimes replace a distinct type of steroid produced in the body naturally. The body can halt making this when someone is on corticosteroids for an extended period. In numerous cases, adrenal suppression corrects itself in time.

In some cases, stopping steroids suddenly causes an "adrenal crisis." This is where levels of cortisol dramatically drop in your body. It is a life-threatening emergency.


Final Note

There is no cure for asthma. However, treatment and an asthma action plan for your child can help you manage it. The method may include monitoring, avoiding triggers, and using medicines.


References:

Asthma Organization United Kingdom. https://www.asthma.org.uk/globalassets/publications.pdf.

National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166064.