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There is no drug that worries parents more than corticosteroids. When I ask why parents are reluctant to give their child corticosteroids, fears of side effects often come up – thinning of the skin, poor growth, diabetes… Therefore, I want to tell you a little about corticosteroids, different types of corticosteroid treatments and its side effects.
What are corticosteroids?
Corticosteroids, or steroids, is the collective name for a group of different molecules that have the same effect as the vital hormone cortisol. Cortisol is formed by the adrenal gland and has a variety of effects on the body. To understand how important it is, I will tell you what problems arise for those who do not produce cortisol at all. A child who does not produce cortisol (a very unusual disease, but does occur) becomes tired, listless, nauseous, vomits, does not grow well, has low blood pressure and may have very low blood sugar without feeling it. Their salt level is, also, out of balance. Here’s an example. If a child who cannot produce cortisol gets a stomach bug, or a fever, the child can die within hours. This is because cortisol is absolutely necessary for the body’s defense against infection, and to trigger the body’s defense against fluid losses and excessively low blood pressure.
Cortisol is therefore both natural, or produced by our body, and vital!
Corticosteroids are a type of anti-inflammatory
Corticosteroids are a type of anti-inflammatory and treats diseases causing inflammation. Therefore, they are important in treating diseases.
Long term treatment of high dose corticosteroids causes severe side effects
Children with severe inflammations sometimes receive high doses of corticosteroids in tablet form, or in drips for a short or long period. These children get high doses of corticosteroids in the blood and consequently side effects. The three side effects that commonly occur on the first day of treatment are:
1. Wakefulness Children often have difficulty sleeping.
2. Mood swings. Children often become more rowdy, sometimes depressed, and sometimes upset. In my experiences, children commonly become more noisy.
3. Increase in appetite Children want to eat a lot of food, and often.
If the treatment is allowed to last for longer than a few weeks, the increase in appetite often results in weight gain. I always advise parents to give children the same portion size as before the treatment. And if they want extra snacks and evening meals, then give carrot sticks and cucumber sticks. Acid reflux is also common.
If the treatment lasts longer, the weight gain often settles on the abdomen and cheeks. At the same time, the muscles are broken down, which gives fat but rather sticky legs. Children can develop diabetes and stomach ulcers. Length or height growth is poor.
After a while, the body thinks that the adrenal glands no longer need to produce cortisol because so much comes from the medicine. Therefore, you must never stop a high-dose cortisone treatment, abruptly. Corticosteroids need to be tapered down slowly. Otherwise, life-threatening symptoms similar to those of other types of cortisol deficiency may occur. Follow the doctor’s prescription!
Lower doses of corticosteroid tablets have fewer side effects
Doctors who treat children with high-dose corticosteroids always try to reduce the dose as quickly as possible, taking into account the risks of the disease returning. Many children then stay on a low dose for a long time to prevent the disease from returning.
Single high doses of corticosteroids do not cause long-term side effects
Children with croup, intrinsic asthma or with severe allergic reactions, often receive a single high dose of corticosteroids in the pediatric emergency room. Children can have difficulty sleeping, and they can also have mood side effects for a few days. However, receiving single such doses does not cause long-term side effects. Height can probably be affected for a short time. However, if your child does not receive repeated doses often, then they grow accordingly to compensate.
Corticosteroid nasal spray is safe to give to children
Nasal sprays with corticosteroids (Nasonex, mometasone, Mommox, Orimox and more) are safe to give to children. Corticosteroid nasal spray is good for allergic nasal congestion. It is often given as a trial, even for chronic nasal congestion where as allergy is not confirmed.
Some children find the nasal spray stings, and some get nosebleeds as a side effect. However, Nasonex and similar nasal sprays are not absorbed into the bloodstream and do not cause systemic side effects.
Nasal sprays with corticosteroids are good for pollen allergy.
Corticosteroid inhalers to treat asthma has few side effects
Inhaled corticosteroids for asthma treatment (Pulmicort, Flutide, Giona Easyhaler, Symbicort in the several orange or brown spray cannisters) is absorbed into the blood to a very small extent. Treatment with asthma inhalers therefore never gives the side effects that high-dose cortisone treatment in tablets or drops gives.
Untreated asthma results in poor growth and poor quality of life in children. It also results in poorer muscle development as children with untreated asthma do not move as much as other children. In order for children with asthma to grow optimally, their asthma should be treated optimally. This often means inhaling corticosteroids every day.
If your child has asthma and you want to minimize possible side effects, you should give the inhalations via a spacer. Corticosteroid inhalations reduce the risk of admittance to the pediatric emergency room. If your child is admitted with an asthma attack, they will immediately receive a large dose of corticosteroid tablets with a greater risk of side effects.
Corticosteroid creams are an effective treatment against eczema
Corticosteroid creams, which are effective against eczema, are available in four different strengths: weak, medium, strong and extra strong. Their side effects differ between groups.
Weak corticosteroid creams are not absorbed into the bloodstream
All over-the-counter corticosteroid creams belong to the weak group. Hydrocortisone 1%, Mildison lipid are weak corticosteroid creams. They are not absorbed into the bloodstream at all and the only side effect we sometimes see is contact allergy to the drug itself. The side effect is rare, but worth considering if the child’s eczema gets worse and not better from the treatment.
I treat my own children with weak corticosteroid creams as soon as they get eczema. When the eczema is gone, they receive treatment every other day for a while and then stop. Then moisturiser is applied until it comes again. When the eczema reoccurs, I use hydrocortisone again, as much and for as long as needed.
Medium-strength cortisone creams can be absorbed into the bloodstream
Medium-strength cortisone creams, such as Locoid 0.1% or Emovat 0.05%, are prescription-only. They are used when weak corticosteroid creams fail to treat the eczema. Unlike weak corticosteroid creams, they can be absorbed into the bloodstream. The more you apply, the more it absorbs. However, you won’t see the side effects you see with high-dose tablet treatment. Not even for long treatment periods. When the eczema is clearly better, try switching to a weak corticosteroid cream. Follow the instructions given to you by your child’s doctor!
Strong corticosteroid creams often cause skin side effects
Strong corticosteroid creams, such as Elocon 0.1% and Betnovat 0.1%, I use less often for children. With long-term use (ie. months), they can cause skin thinning, stretch marks and they are definitely be absorbed into the bloodstream. However, strong corticosteroid creams also do not cause the side effects that high-dose corticosteroid tablets cause. When the eczema has clearly improved with strong corticosteroid creams, you switch to medium-strength ones. If the eczema is stubborn, however, you may need to continue applying the strong cream once a week to prevent relapse. Follow the instructions given to you by your child’s doctor!
Extra strong corticosteroid creams
Extra strong corticosteroid creams such as Dermovat 0.05% are not used on children.
The percentage says nothing about the strength of creams!
Notice in the examples above, that the strongest cream has a much lower percentage than the weakest! I included the percentages to demonstrate. Make sure that the tube is clearly labelled weak, medium or strong corticosteroid cream.
Hii ni kwa sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu ya sababu. "Wazazi wanapokuwa wakijaribu kumpa mtoto wao dawa ya ""corticosteroid,"" mara nyingi wanahofu athari zake za upande, kama vile ngozi inayopungua, kukua vibaya, ugonjwa wa kisukari, na hivyo, kwa hivyo, nataka kukuambia kidogo juu ya dawa za ""corticosteroid,"" aina tofauti za matibabu ya ""corticosteroid"" na athari zake." Kortikosteroidi ni nini? Kortikosteroidi ni jina la pamoja kwa kundi la molekuli tofauti ambazo zina athari sawa na homoni muhimu ya cortisol. Cortisol hutengenezwa na tezi-juu ya kichwa na ina athari mbalimbali kwenye mwili. Ili kuelewa umuhimu wa cortisol, tafadhali tazama jinsi inavyoweza kuathiri watu ambao hawana uwezo wa kutoa cortisol. Mtoto ambaye hatokezi cortisol (ugonjwa usio wa kawaida sana, lakini hutokea) anakuwa amechoka, hana hamu, ana kichefuchefu, anaanza kutapika, hakua vizuri, ana shinikizo la chini la damu na anaweza kuwa na sukari ya chini sana katika damu bila kuiona. Kiwango cha chumvi yao, pia, hakiko sawa. Hapa ni mfano. Ikiwa mtoto hawezi kutokeza cortisol anapata ugonjwa wa tumbo, au homa, mtoto anaweza kufa kwa muda wa saa chache. Hii ni kwa sababu cortisol ni muhimu sana kwa ulinzi wa mwili dhidi ya maambukizo, na kuamsha ulinzi wa mwili dhidi ya hasara ya maji na shinikizo la chini la damu. Kwa hiyo, kortizoli ni ya asili, au hutengenezwa na mwili wetu, na ni muhimu! Corticosteroids ni aina ya dawa ya kuzuia uvimbe na ni dawa ya kuzuia uvimbe. Kwa hiyo, ni muhimu katika kutibu magonjwa. Matibabu ya muda mrefu ya dawa za kulevya za kortikosteroidi husababisha athari mbaya za upande, kwa hivyo watoto wenye uvimbe mkubwa wakati mwingine hupokea dawa za kulevya za kortikosteroidi kwa fomu ya kibao au kwa matone kwa muda mfupi au mrefu. Watoto hao hupata dozi kubwa za kortikosteroidi katika damu na kwa hiyo athari za upande. Madhara ya kawaida ya kwanza ya matibabu ni: Mara nyingi watoto huwa na matatizo ya kulala. 2. Uwezekano wa kupata Mabadiliko ya hisia. Mara nyingi watoto huwa wenye ghasia zaidi, nyakati nyingine huwa na mshuko wa moyo, na nyakati nyingine huwa na hasira. Kwa uzoefu wangu, kwa kawaida watoto huwa na kelele nyingi zaidi. 3. Uwe na mtazamo wa kweli Kuongezeka kwa hamu ya kula Watoto wanataka kula chakula kingi, na mara nyingi. Ikiwa matibabu yanaruhusiwa kudumu kwa muda mrefu kuliko majuma machache, kuongezeka kwa hamu ya kula mara nyingi husababisha kuongezeka kwa uzito. Kwa hivyo, wazazi wanapaswa kuwapa watoto wao vipimo vya chakula sawa na vile walivyokuwa kabla ya matibabu. Ikiwa unataka chakula cha jioni cha ziada, basi weka mikate ya karoti na mikate ya matango. Mshuko wa asidi pia ni wa kawaida. Matibabu ya muda mrefu zaidi huongeza uzito wa tumbo na mashavu. Wakati huohuo, misuli huvunjika, na hilo hutokeza miguu yenye mafuta lakini yenye kunata. Watoto wanaweza kupatwa na ugonjwa wa kisukari na vidonda vya tumbo. Ukuaji wa urefu au urefu ni duni. Baada ya muda, mwili hufikiri kwamba tezi za adrenal hazihitaji tena kutokeza cortisol kwa sababu mengi hutoka kwa dawa. Kwa hiyo, hupaswi kamwe kuacha matibabu ya cortisone yenye kipimo cha juu, ghafula. Dawa za corticosteroid zinahitaji kupunguzwa polepole. Vinginevyo, dalili zenye kuhatarisha uhai zinazofanana na zile za aina nyingine za upungufu wa cortisol zaweza kutokea. Fuata maagizo ya daktari! Dawa za kortikosteroidi za kiwango cha chini zina athari chache za upande, na madaktari wanaotumia dawa za kortikosteroidi za kiwango cha juu kwa watoto hujaribu kupunguza kipimo haraka iwezekanavyo, kwa kuzingatia hatari ya ugonjwa kurudi. Watoto wengi kisha kubaki juu ya kipimo cha chini kwa muda mrefu ili kuzuia ugonjwa kutoka kurudi. Dawa ya kortikosteroidi ya mara moja ya kiwango cha juu haisababishi athari za muda mrefu kwa watoto walio na croup, asthma ya ndani au na athari kali za mzio, mara nyingi hupokea dozi moja ya kortikosteroidi ya kiwango cha juu katika chumba cha dharura cha watoto. Watoto wanaweza kuwa na matatizo ya kulala, na wanaweza pia kuwa na athari za hali ya moyo kwa siku chache. Hata hivyo, kupokea dozi moja kama hizo hakusababisha athari za muda mrefu. Huenda urefu ukathiriwa kwa muda mfupi. Hata hivyo, ikiwa mtoto wako hapati dozi mara kwa mara, basi hukua ipasavyo ili kulipia. Kuna dawa za kuzuia ugonjwa wa kifua na corticosteroids (Nasopress, Mimetasone, Mommox, Orimox, na mengineyo) ambayo inaweza kutumika kwa watoto. Kiyoyozi cha pua cha kortikosteroidi ni kizuri kwa ugonjwa wa kuvimba kwa pua. Mara nyingi hutolewa kama jaribio, hata kwa msongamano wa pua wa kudumu ambapo kama mzio haujathibitishwa. Watoto fulani hupata kwamba dawa hiyo ya kunyunyizia pua huwa na vidonda, na wengine hupata damu kutoka kwenye pua kama athari ya upande. Hata hivyo, Nasonex na dawa kama hizo za kunyunyizia pua hazipatikani katika mtiririko wa damu na hazisababishi madhara ya mfumo. Vipuli vya pua vyenye kortikosteroidi ni vyema kwa mzio wa chavua. Inhalers ya corticosteroids kwa asthma (Pulmicort, Fluid, Gena Easyhaler, Symbicort katika canisters kadhaa za rangi ya machungwa au kahawia) huingizwa katika damu kwa kiwango kidogo sana. Kwa hiyo, matibabu ya dawa za kupumua za pumu hayana madhara kama yale ya matibabu ya cortisone yenye kipimo cha juu katika vidonge au matone. Asma isiyotibiwa husababisha ukuzi mbaya na ubora mbaya wa maisha kwa watoto. Pia husababisha maendeleo duni ya misuli kwa kuwa watoto wenye pumu wasiotibiwa hawawezi kusonga kama watoto wengine. Ili watoto wenye pumu wakue vizuri, pumu yao inapaswa kutibiwa vizuri. Mara nyingi hilo humaanisha kupumua kortikosteroidi kila siku. Ikiwa mtoto wako ana pumu na unataka kupunguza athari zinazowezekana, unapaswa kutoa pumzi kupitia spacer. Inhalations corticosteroid kupunguza hatari ya uandikishaji kwa chumba cha dharura pediatric. Ikiwa mtoto wako anapata ugonjwa wa pumu, atapewa mara moja kipimo kikubwa cha dawa za corticosteroid na hatari kubwa ya athari za upande. Kwa sababu ya nguvu ya kortikosteroidi, dawa hii inaweza kutumika kwa ajili ya matibabu ya ugonjwa wa eczema, kwa sababu ina nguvu nne: dhaifu, kati, nguvu na nguvu. Madhara yao ya upande hutofautiana kati ya vikundi. Krimu dhaifu za kortikosteroidi hazifuniki katika mtiririko wa damu Krimu zote za kortikosteroidi zinazouzwa bila dawa ni za kikundi dhaifu. Hydrocortisone 1%, Mildison lipid ni cream dhaifu za corticosteroid. Dawa hizo hazipatikani katika damu na athari pekee ya upande ambayo mara nyingi huonekana ni mzio wa mawasiliano kwa dawa yenyewe. Athari ya upande ni nadra, lakini inafaa kuzingatia kama eczema ya mtoto inazidi kuwa mbaya na si bora kutoka kwa matibabu. Mimi hutumia dawa za kupunguza maumivu ya kiakili kama vile corticosteroid na dawa za kuzuia maumivu ya kiakili, kwa sababu watoto wangu wana ugonjwa wa eczema. Eczema inapopungua, matibabu hufanywa kila baada ya siku mbili na kisha huacha. Kisha, hutiwa krimu ya unyevu hadi itakaporudi tena. Eczema inapotokea tena, mimi hutumia hydrocortisone tena, kwa kiasi na kwa muda mrefu kama inahitajika. Kwa mfano, kwa ajili ya matibabu ya ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa wa ugonjwa. Hutumika wakati krimu dhaifu za kortikosteroidi zinashindwa kutibu eczema. Tofauti na krimu dhaifu za kortikosteroidi, zinaweza kufyonzwa katika mtiririko wa damu. Kadiri unavyoitumia, ndivyo inavyoweza kuichukua zaidi. Hata hivyo, huwezi kuona athari za upande unaona na matibabu ya dawa ya kipimo cha juu. Hata kwa vipindi virefu vya matibabu. Eczema inapobadilika, jaribu kutumia krimu yenye kortikosteroidi dhaifu. Fuata maagizo yaliyotolewa na daktari wa mtoto wako! Kwa sababu ya athari za ngozi, dawa za kulevya za corticosteroid kama vile Elocon 0.1% na Betovate 0.1% zinatumiwa mara chache kwa watoto. Kwa matumizi ya muda mrefu (yaani. Kwa sababu ya hali hii, inaweza kusababisha ngozi thinning, stretch marks, na inaweza pia kuingizwa katika damu. Hata hivyo, krimu zenye kortikosteroidi kali hazisababishi madhara yanayosababishwa na vidonge vyenye kortikosteroidi nyingi. Wakati eczema imeboresha wazi na cream kali za corticosteroid, unabadilika kwa zile zenye nguvu za kati. Hata hivyo, ikiwa ugonjwa huo ni mkali, huenda ukahitaji kuendelea kutumia krimu hiyo kali mara moja kwa juma ili kuzuia ugonjwa huo usirudi tena. Fuata maagizo yaliyotolewa na daktari wa mtoto wako! Kwa sababu ya matumizi ya dawa ya steroids ya nguvu, dawa ya steroids ya nguvu kama Dermostat 0.05% haitumiki kwa watoto. Asilimia hiyo haisemi chochote kuhusu nguvu ya krimu! Ona katika mifano iliyo hapo juu, kwamba krimu yenye nguvu zaidi ina asilimia ndogo zaidi kuliko ile isiyo na nguvu zaidi! Niliingiza asilimia za kuonyesha. Hakikisha kwamba tube ni wazi alama dhaifu, kati au nguvu corticosteroid cream.