Great question! Unfortunately, there are side effects to taking steroids – inhaled or oral. However, the risk of suppressing the immune system with inhaled corticosteroids is far less than with the use of systemic steroids.
For a person with asthma, inhaled steroids are an important part of treatment. They reduce the airway inflammation that is the hallmark of asthma. So, when prescribing inhaled steroids most doctors weigh carefully the benefits vs. the risks. Most likely you’re on the lowest possible dose for the severity of your asthma – enough to treat the inflammation and avoid exacerbations. One of the benefits of inhaled steroids is that they are being delivered directly to the area needed, which is one of the reasons a much lower dosing can be used with far less side effects. In fact, it takes about a year of inhaled steroids to equal a 5 day course of oral steroids prescribed during an exacerbation .
ICP increases for all inhaled agents at MAC , and autoregulation is impaired at levels below that. MAC of isoflurane or desflurane decreases CBF during craniotomy for supratentorial tumors [Fraga M et al. Anesthesiology 98: 1085, 2003] but does not affect ICP. In contrast, MAC of iso/des will decrease CBF and raise ICP in pituitary resections, and subjective measures of brain relaxation suggest that 50% NO plus MAC of iso/des provide better relaxation [Miller] All volatile anesthetics reduce evoked potential and can abolish them at MAC (or MAC with 50% nitrous oxide). - MAC can reduce the reliability of evoked potential monitoring [Lotto ML et al. J Neurosurg Anesth 16: 32, 2004] EEG effects of inhaled anesthetics include an initial increase in amplitude and synchrony, followed by periods of electrical silence as doses increase. Between MAC and , an isoelectric pattern emerges. Sevoflurane and enflurane may be associated with epileptic activity on the EEG
The aim of this article is to bring less well recognised adverse effects of inhaled corticosteroids to the attention of prescribers. Whilst inhaled steroids have a more favourable side effect profile than systemic steroids, they are not free from adverse effects. The dose of inhaled steroids used should be carefully monitored, and kept at the lowest dose necessary to maintain adequate control of the patient’s disease process. Be particularly aware of the cumulative effect of co-prescribing various dose forms of corticosteroids (inhaled, intranasal, oral and topical preparations).