Steroid Phobia in Asthma

It has been a long-standing challenge to improve the adherence of asthma medications in paediatric patients.  Parents are often concerned about the side effects of inhaled corticosteroids.  There are valid side effects to be noted, such as oral candidiasis which is preventable, and possible reduction in growth and final height by about 1 cm.  But the benefits of long term use of inhaled corticosteroids are still greater because it can prevent future asthma attacks.

Some experts have pointed out that there is currently inadequate education and support to parents about the knowledge of asthma, the roles of different medications as well as proper techniques of using the inhalers.  These are all important areas to explain to parents.

But I wonder if  it isn’t inadequate education but rather ineffective method of delivering the message?  

After all, it isn’t a straight forward condition to explain quickly.  You have to explain the disease, the inflammation, the roles of different medications, how to identify when asthma is worsening as well as the need to develop an asthma action plan.

Below I offer a different way to explain why we need to give inhaled steroid to control asthma and to prevent future attack.


Ok, there is some exaggeration here. But the point is that the amount of steroid you give to your child is a lot less in prevention, than when your child may receive during an acute asthma attack.

I think it is a better way to explain to parents.  What do you think? Thank you for reading my post.


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My name is Cynthia Leung and I am a practicing pharmacist in Kingston Ontario, Canada. This blog is for me to share my ideas, opinions and perspectives on how medications are used in our health care system. Note that these posts are my own opinions and do not represent the opinions of my current or former employers and / or organizations that I may belong to. Any possible case scenarios described in my posts would be modified to maintain patient confidentiality. This blog is not a platform for professional advise for patients or health care providers and the content is not meant to support any clinical decisions or replace professional opinions. Also the images are either taken or created by the author, or adapted with permission. I hope you will enjoy reading my posts!

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