Health Information
The Use of Steroids

Introduction
Steroids (prednisone, methylprednisolone, and dexamethasone) have been used to treat asthma and other lung diseases for over 25 years.  They are the most potent drugs used to treat asthma but, unfortunately, also have the largest number of unwanted side effects. When used to treat asthma, steroids decrease the swelling and inflammation of the airways, thus relieving symptoms. These drugs can also reduce the inflammation associated with fibrosis of the lungs (scarring) and sarcoidosis. Steroids are prescribed only when they are required for treatment and when drugs with fewer side effects are not effective.

Short Term Side Effects
Side effects associated with short courses of steroids (less than one month) include the following:  edema (swelling, especially of the legs or face), emotional problems (such as depression, euphoria and/or irritability), insomnia, confusion, stomach ulcers, appetite stimulation, muscle weakness, blurry vision, leg cramps, sweating and acne.  Short course steroids may also raise the blood sugar in patients with diabetes or elevate blood pressure in patients with hypertension requiring close monitoring. The side effects from short course steroids can usually be controlled with appropriate medications, or reducing the dose of steroids.

Long Term Side Effects
Side effects caused by long term use of steroids (longer than one month) include the following:  osteoporosis (fragile and weak bones), easy bruising of the skin, cataracts, weight gain with fullness in the face, increased risk of stomach ulcer, increased risk of infection, and suppression of adrenal function.  Take oral steroids as directed (usually prescribed once a day) and with food to decrease stomach irritation. These risks of long term steroid therapy can be reduced by taking steroids as a single dose every other morning.

Cautions
When steroids have been taken for longer than one month, they must not be abruptly stopped. The dose needs to be gradually reduced to allow the adrenal glands sufficient time to regain their normal function.  Full recovery of the adrenal function may take as long as 9 months after steroid therapy has been stopped. Patients on prolonged steroid therapy (or within 9 months of stopping prolonged steroids) who are under severe stress, such as surgery or severe infections, should have their dosage temporarily increased. The dosage of steroids should not be increased without directions from a physician. 

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