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Respiratory Disorders (Expert Forum)
oral steroids vs. pulse steroids
Answered by
This forum is for questions and support regarding lung and respiratory issues such as: Allergies, Asthma, Bronchitis, Colds - Flu, Chronic Cough, COPD, Cystic Fibrosis, Emphysema, Fibrosis, Lung Abscess, Nasal Polyps, Pleurisy, Pneumonia, Sarcoidosis, Sinusitis, Tuberculosis.
oral steroids vs. pulse steroids
by CINDY4, Oct 25, 2004 12:00AM
My 10 yr old daughter has severe asthma, and eosinophilic pneumonia. She has been on systemic steroids for 3 years. She has experienced many side effects during this time. For 6 months after the eosinophilic pneumonia was diagnosed she took pulse steroids 750mg 3x monthly. During this time it was the only time her stomach did not kill her. She also has eosinophilic gastroenteritis, and is also very sensitive GI wise to steroids. She has gotten bleeding ulcers before from her daily steroid use. I have read some articles saying pulse steroids in the long run have less side effects than daily low dose prednisone. Her main dr does not agree and says if she were left on a pulse of say..500mg 2 x monthly, she would end up blind with no joints and her bones rotted out. The only time she feels well is on the pulses, her stomach is great. We have also recently had to start chemo to help control all the eosinophilic inflammation, all of which hurts her already sensitive stomach. So which is better long term daily oral 10mg, for years or 2 pulses a month of 500mg Solumedrol. WHich is likely to have less side effects. Her drs are not in agreement on this.
Cindy
Cindy
Doctor's Answer
by National Jewish, Nov 10, 2004 12:00AM
, Nov 10, 2004 12:00AM
This is a difficult situation. Prednisone 10mg daily can be tolerated well by most adults for years. However this has more side effects in growing children. The high doses carry the additional problem of markedly increasing the risk of life threatening infections. The best approach is to find an immunosuppressive medicine, which can take the place of the steroids.
To lessen or avoid steroid side effects the dose is decreased as soon as possible to the lowest dose that helps. Often adding other medicines, like a proton pump inhibitor, may help the eosinophilic gastroenteritis symptoms. This could make it possible to decrease or eliminate the steroid dose. When steroids are needed to treat eosinophilic gastroenteritis it is very important to be seeing a gastroenterologist for care on a regular basis. This specialist will let you know if further testing is needed to see if there are other problems causing your daughter’s stomach to hurt. By finding and treating these other problems it may be possible to decrease the steroids. This specialist will continually try to decrease the dose of steroids and watch for its potential side effects.
Many side effects are possible from steroids. As you have seen in your daughter, side effects such as bleeding ulcers are possible. There are other potential side effects from taking steroids. If they start the steroid side effects that will last the rest of her life are cataracts, glaucoma, diabetes, and osteoporosis. Please check with her doctor about steps to take to:
1) lessen the side effects;
2) prevent further side effects; and
3) watch for potential side effects.
To decrease the risk of her bones thinning you will need to be sure that your daughter is getting enough calcium and vitamin D. Please read about Corticosteroids at http://asthma.nationaljewish.org/treatments/longterm/inhaled_oral.php for further information about the side effects and their prevention. When steroids are needed to treat eosinophilic pneumonia it is very important to be seeing a pulmonologist for care on a regular basis. This lung specialist will continually try to decrease the dose of steroids and watch for its potential side effects.
To lessen or avoid steroid side effects the dose is decreased as soon as possible to the lowest dose that helps. Often adding other medicines, like a proton pump inhibitor, may help the eosinophilic gastroenteritis symptoms. This could make it possible to decrease or eliminate the steroid dose. When steroids are needed to treat eosinophilic gastroenteritis it is very important to be seeing a gastroenterologist for care on a regular basis. This specialist will let you know if further testing is needed to see if there are other problems causing your daughter’s stomach to hurt. By finding and treating these other problems it may be possible to decrease the steroids. This specialist will continually try to decrease the dose of steroids and watch for its potential side effects.
Many side effects are possible from steroids. As you have seen in your daughter, side effects such as bleeding ulcers are possible. There are other potential side effects from taking steroids. If they start the steroid side effects that will last the rest of her life are cataracts, glaucoma, diabetes, and osteoporosis. Please check with her doctor about steps to take to:
1) lessen the side effects;
2) prevent further side effects; and
3) watch for potential side effects.
To decrease the risk of her bones thinning you will need to be sure that your daughter is getting enough calcium and vitamin D. Please read about Corticosteroids at http://asthma.nationaljewish.org/treatments/longterm/inhaled_oral.php for further information about the side effects and their prevention. When steroids are needed to treat eosinophilic pneumonia it is very important to be seeing a pulmonologist for care on a regular basis. This lung specialist will continually try to decrease the dose of steroids and watch for its potential side effects.
