Nebulisers should only be used for a young child who cannot manage any inhalers or who has brittle asthma - attacks that build up rapidly with no warning and are life threatening.
If your child inhales steroids via a nebuliser, then she should wear goggles to decrease the risk of glaucoma and carefully wash the face afterwards.
Side-effects:
Asthma drugs do have side-effects. Which ones will depend on the amount of medication she is taking and her individual susceptibility.Bronchodilators have been associated with the following side-effects - increased heart rate, trembling and headaches. Several studies have indicated that the overuse of relievers can make asthma worse. They should be used only as needed.
Parents are particularly concerned when their child is taking steroids from a young age. When taken orally they can produce alarming side effects, including:
- suppression of growth
- adrenal suppression
- thinning of bones
- “moon” shaped face
- impaired skin collagen synthesis, skin thinning and increased bruising
- cataracts - especially during treatment with nebulised steroids which may
- expose the eyes to high doses
- metabolic disturbances
- diabetes
- effect on central nervous system.
- acne
- Increased blood pressure
If you child has been on oral steroids for more than a few weeks, he or she needs to come off them gradually and under medical supervision. A sudden withdrawal of steroids can make asthma life-threatening.
Inhaled steroids are not as strong as oral steroids and consequently, they have less side effects. However they may have similar side effects if taken in large quantities or when taken over a long period.
In childhood the suppression of growth is the main concern of steroid therapy. Recent controlled clinical studies suggest that inhaled corticosteroids may cause a small reduction in the rate of growth in children. The average reduction in growth rate observed in the studies was about one centimeter (a third of an inch) per year.
Growth retardation has not been reported when inhaled corticosteroid doses were less than or equal to 400 micrograms. However, some cases with individual reactions to low doses of inhaled steroids are known: therefore, close clinical control of children on inhaled steroids is extremely important. It is recommended that children not take more than 800 mcg daily.
Minor side effects of taking inhaled corticosteroids common in 10 to 30% of people taking them are oral candidiasis, dysphonia and coughing.
While all of these side-effects sound alarming, you have to balance them against the severity of your child’s condition. Asthma can range from being a slight nuisance to debilitating and life-threatening. So the risks of the treatment need to be weighed up against the benefits of controlled asthma.
To effectively manage Asthma
- It is important for you and your child to establish which triggers cause attacks
- Monitor asthma on a day-to-day basis to ensure symptoms are not worsening
- Recognise the signs of an imminent attack
- Use your management plan to get asthma under control again
- Seek medical advice if (A) reliever medication becomes less effective and is required on a more frequent basis, (B) if you or your child become frightened by the severity of the attack.
(published with permission in writing from:http://www.buteyko.co.nz)
