NHS England » RightCare asthma scenario

There is no experience with or evidence of safety of propellant HFA-134a in human pregnancy or lactation. However, studies of the effect of HFA-134a on reproductive function and embryofetal development in animals have revealed no clinically relevant adverse effects. Adrenocortical function should be monitored regularly as the dose of systemic steroid is gradually reduced.

• The Asthma UK website has videos explaining how to use the different types of inhaler.
• If you need to take a high dose during pregnancy, you may need regular check-ups to check for any side effects.
• There is limited evidence in the area of monitoring/management during the discontinuation of long term steroid therapy.
• If your child is taking high doses of steroid medicine, they should carry a steroid card which their GP, asthma nurse, or pharmacist can give them.

Steroid replacementIf you’re having steroid treatment to help manage a condition such as Addison’s disease or a pituitary disorder, this shouldn’t harm your bones as long as you are receiving the right amount of steroid. It’s important that this is monitored, as receiving more steroid than you need could cause bone loss. Into a jointJoint injections are sometimes used to reduce inflammation in the affected area if you have arthritis.

Are there any side effects?

In that case, that is fine – they are available to collect at your community pharmacy & the Surgery. All patients taking ICS who have never had chickenpox should be advised to avoid people with chickenpox or shingles, and to see a doctor if they come in contact with someone with either illness and then feel unwell. If you have concerns about the environmental impact of inhalers, it’s good to know that alongside considering the best device for you and your asthma, your GP can also look at the carbon footprint of different inhalers.

• This is particularly important if you’ve been using or want to use other medicines that contain corticosteroids, for example steroid nasal sprays for hayfever, or steroid creams for eczema.
• Close monitoring and consideration of the possible side effects is therefore essential.
• But if you use them for a long time, or at a high dose, you might absorb more of the medication and have a higher risk of side effects.
• However, these animal experimental results are not relevant in humans at the recommended doses (see section 4.6).
• Candidiasis of the mouth and throat occurs in some patients, the incidence increasing with doses greater than 400 micrograms beclometasone dipropionate per day.
• All patients taking ICS who have never had chickenpox should be advised to avoid people with chickenpox or shingles, and to see a doctor if they come in contact with someone with either illness and then feel unwell.

Therefore, we will be identifying patients opportunistically during their asthma or COPD annual reviews & by using computer searches, & directing patients/ carers to this webpage for further information. When this happens, the body may reduce its own production of corticosteroids. This is the body’s main stress hormone, so it is particularly important during periods of injury or illness. The reason for this difference in efficacy may be related to the mechanism of action of ICS.

Discontinuing steroid (Duration of treatment > 6 months)

There was a sustained effect over the 24-week treatment period in both studies, and over 52 weeks in ETHOS. In both studies, benefits on exacerbations were observed in patients with moderate, severe and very severe COPD. Budesonide is a glucocorticosteroid which when inhaled has a rapid (within hours) and dose dependent anti-inflammatory action in the airways. In addition, L-dopa, L-thyroxine, oxytocin and alcohol can impair cardiac tolerance towards beta2-sympathomimetics.

What care will be given to my child during their time in hospital?

Your doctor may say you can stop the osteoporosis medication if you were only prescribed it because you were taking steroid tablets. But if your risk of breaking a bone is still higher, your doctor may suggest staying on an osteoporosis medication for longer, before possibly steroids for sale online uk having a pause in treatment after five years. This pause in treatment – sometimes called a ‘drug holiday’ – will only be suitable if you’re on a bisphosphonate drug, such as alendronate. The thought that your medicine could cause side effects can be worrying.

It is unlikely that this medicinal product administered at the recommended dose will affect fertility in humans. Β-adrenergic blockers (including eye drops) can weaken or inhibit the effect of formoterol. Concurrent use of β-adrenergic blockers should be avoided unless the expected benefit outweighs the potential risk. If β-adrenergic blockers are required, cardio-selective β-adrenergic blockers are preferred.

Information point 4: Ensuring everyone has a Personalised Asthma Action Plan (PAAP)

The reliever inhaler doesn’t work and she is taken to A&E via ambulance where she has a similar experience as before. She is discharged, again with a course of oral steroids for seven days and with the advice to see her GP. These medicines can therefore increase your exposure to fluticasone and salmeterol and so may increase the risk of side effects on the rest of the body. The antifungals ketoconazole and itraconazole should be used with caution in people using Seretide.

Do not smoke though, as this can make your medicine less effective and make your symptoms worse. Steroid inhalers usually cause few or no side effects if used correctly and at normal doses. Using a steroid inhaler too much over a long period can increase your chances of getting side effects.

The aim is always to manage your child’s asthma on the lowest dose possible. Montelukast is not a steroid – it works in a different way to reduce inflammation. For some children it is a good alternative to higher doses of inhaled steroids. In that case, with your GP’s advice, your child can come off the preventer inhaler.