Steroids for asthma

Reviewed by:
Dr. Robert Kwok
Director of Health Informatics
Last updated on January 20, 2022 UTC

Steroids (the category called corticosteroids or glucocorticoids) are among the most important anti-inflammatory drugs used in the treatment of asthma. They reduce the inflammation of the airways to make them less reactive to asthma triggers. Corticosteroids are helpful in reducing the severity of asthma as well as the number of acute attacks. They restore the quality of life of people living with asthma by helping them breathe better and lead normal lives without physical limitations. 

How do steroids work in the body?

This category of steroids works by activating the glucocorticoid receptors in the body. The stimulation of these receptors causes a wide range of responses in the body, such as:

  1. Lowering of inflammation – in diseases such as asthma, inflammation is responsible for the airway swelling and narrowing that causes difficulty in breathing. Hence, steroids are useful in controlling the severity of asthma.

  2. Calming the immune response – by lowering the immune response, the steroids reduce the inflammatory cells in the airways which are responsible for the creation of chemicals that cause more inflammation. 

Various formulations of steroids: 

1)      Pill – a simple tablet that can be swallowed with water. Steroid pills for asthma are used in severe cases that are not controlled with common asthma inhalers.

2)      Syrup – formulated for small children who cannot swallow the tablets.

3)      Inhaler – breathing pump for asthma that delivers a metered dose into the lungs.   

4)      Respule – contains a liquid medicine. An electronic nebulizer turns this liquid into a mist that can be inhaled easily.

5)      Nasal spray – used in conditions such as allergic rhinitis or nasal polyps.

6)      Ointment – applied directly onto the skin. Ointments, creams, lotions, and gels are useful in skin disorders such as atopic dermatitis. 

7)      Enema – rectal enemas are for inflammatory conditions affecting the bowel such as ulcerative colitis.

8)      Injection – the medication is injected into the body, such as into a vein or muscle.

 

What is the role of steroids in treating asthma?

Millions of people across the United States suffer from asthma each year. Asthma is a chronic inflammatory condition that affects the airways of the lungs. The inflammation is responsible for the swelling and narrowing of the airways. Asthma patients often experience dyspnea (shortness of breath), cough, and wheezing which is a whistling sound heard while breathing out during an asthma attack.

In asthma patients, steroid medications:

  • Lower the inflammation of the airways

  • Are the best medication for asthma attack prevention

  • Make the airways less reactive to asthma triggers

  • Lessen the disease severity

  • Help restore the quality of life of people living with asthma

  • Decreases emergency hospital admissions

  • Reduces the mortality rate from asthma

Now, let's have a look at the steroid-containing types of asthma medications and their uses.

Inhaled steroids

  • Used in cases of moderate or persistent asthma

  • Associated with fewer side effects than oral steroids

  • Can be used for long-term 

  • Examples – fluticasone, budesonide, mometasone, beclomethasone

Oral steroids

  • Used in cases of severe asthma

  • Associated with more side effects than inhaled steroids

  • Short-term use in asthma

  • Examples – prednisolone, methylprednisolone, dexamethasone, prednisone

 Injectable steroids

  • Used in severe attacks of asthma

  • Given in a clinic or hospital setting

Steroids are mainly used for preventing future attacks of asthma. Hence, they are commonly called controller medications for asthma.

Unlike steroids, an albuterol inhaler is a common emergency asthma medication that comes in handy for immediate control of asthma symptoms. It can quickly dilate the airways which help the person breathe better immediately during an attack.

If asthma is not treated properly with preventive medications, there is an increased chance of suffering an asthma attack. Book an appointment with a HealthTap doctor to discuss treatment options for asthma in detail.

Can an asthma attack kill you?

Yes, an asthma attack can be fatal especially when it is not treated in time. With the use of steroids, the frequency of acute attacks, hospital admission rates, and mortality has gone down drastically. Smoking with asthma is bad and worsens symptoms – smoking with asthma can kill you also by increasing the chances of contracting a serious infection or other lung diseases such as chronic bronchitis and emphysema.

What kind of doctors do you see for asthma?

  • Primary care provider – the first point of contact for healthcare

  • Pulmonologist – a specialist in treating various conditions affecting the lungs

  • Pediatrician – specialist or primary care doctor who cares for children below 18 years

  • Allergist – a specialist who deals in allergies, asthma, and also immune system issues

Can you get steroids over the counter?

Almost all steroid medications cannot be bought over the counter. Steroids require a prescription from a doctor. Over-the-counter exceptions include mild steroid creams for skin conditions and some steroid nasal sprays for allergies.

Steroids are not sold without prescription because they can cause possible serious side effects, especially if overused without a doctor’s supervision.

Most side effects of steroids are dose-related which means the higher the dose, the more likely the side effects. Hence in patients with asthma, doctors note the disease severity and carefully adjust the dose according to the need. One of the worrisome complications of steroid use is the suppression of immune function, which puts a person at increased risk of catching infections.

Some possible side effects of steroid use are:

  • Hyperglycemia - raised blood sugar levels

  • Infections

  • Oral thrush – infection of the mouth by the yeast

  • Headache

  • Cough

  • Hypertension – increased blood pressure

  • Glaucoma – increased pressure of the eyeballs

  • Cataract – opacification of the lens of the eye

  • Osteoporosis – Weakening of bones

Can you order asthma inhalers online?

HealthTap is a virtual clinic where you can ask about getting asthma medications online. Connect with an online primary care doctor at HealthTap and see if it is appropriate for you to get an asthma prescription online in the comfort of your home. The best doctors for asthma usually are people’s own primary care doctors.

Self-care

  • Avoid known allergens or triggers

  • Stay indoors on high-pollen days, or wear a mask

  • Exercise regularly

  • Invest in a HEPA room air purifier

  • Relaxation and breathing exercises

  • Avoid exposure to very cold air

  • Take your medications on time and as per your doctor’s instructions

  • Always keep a supply of asthma medications so not to run out unexpectedly

  • Contact your HealthTap doctor or in-person doctor in case there is a change in the pattern of symptoms

Learn how HealthTap can help you

Share:

More articles in Asthma

Not just a doctor —
your doctor