Inhalation steroids, some aspects and ways in the management of asthma.

Inhalation of steroid is important in the management of asthma and at present various steroids are available for inhalation. Aerosol treatment with steroids is most effective if used in several doses throughout the day. In moderately severe asthma it may be ineffective until airways are cleared by adequate oral doses. There are several methods of inhalation eg, metered dose inhalation, dry powder inhalation and nebulisation. The pressurised metered dose inhaler is widely used for its main advantage of compactness, convenience and readiness for use. Powdered inhalers are considered safe especially for use in children. No co-ordination is required by the patient in cases of administration by nebulisation. Inhaled route is preferred to systemic route because of its better therapeutic index ie, fewer side-effects for equivalent clinical effects. But poor inhalation technique is the reason for failure of aerosol steroids.