Missed Medications
Sometimes, even those children who consider their asthma to be under control can end up in the hospital emergency department with an asthma flare-up. Exposure to high levels of allergens (molds, pollens) or irritants (wood smoke, ozone), a particularly difficult virus, not keeping up with immunizations, or not taking medication as prescribed all can trigger asthma symptoms — and lead to seeking emergency care.
Inhaled Corticosteroids
Many of these hospitalizations for asthma, though, may be the result of not taking prescribed daily inhaled corticosteroid medications that are recommended to control airway inflammation, according to one study.
In the study, the overall adherence to inhaled steroids was found to be about 50 percent. Those patients who missed one out of four doses of their prescribed inhaled steroid were found to have doubled their risk of being hospitalized.
Approximately 60 percent of hospitalizations could have been prevented if the patients had taken their inhaled medications as directed.
Reliance on Quick-Relief Medications
Sometimes children may not be taking their inhaled corticosteroids all the time because they have found they can get relief — albeit temporary — from using their quick-relief medications when symptoms flare up.
Alert!
Flare-ups are triggered by inflammation of the airways, which require daily medication. When the quick-acting medications wear off, the natural instinct is to use more. However, during that period, symptoms that are due to inflammation may have been getting worse throughout their airways for the past several hours.
If you notice your child using her quick-relief inhaler repeatedly during the day, find out when she last used her long-term control medication. And, monitor her symptoms and determine what they indicate on her asthma action plan.
Prednisone — Now?
The oral corticosteroid, prednisone, is used to decrease swelling and inflammation of the airways that can lead to an asthma flare-up. Oral corticosteroids also have been linked with serious side effects when they are used long-term; these side effects, though, usually have not been cited with shorter-term use.
When use of prednisone may be indicated for an impending flare-up, you may be tempted to try to wait as long as possible to use it. However, as the inflammation continues, it may become harder to reverse. Using the prednisone sooner — rather than later — could avoid a possible trip to the emergency room — and ironically a week of prednisone to reverse inflammation.
Of course, always check with your health care provider if a flare-up seems imminent and review exactly what symptoms indicate the need to start a medication such as prednisone. But remember to start as soon as appropriate to get it under control, before it becomes more serious.
