Asthma


Use a spacer when using a metered dose inhaler containing an inhaled corticosteroid


The most common side effects of


low-dose inhaled corticosteroids include thrush and throat irritation with hoarse- ness of voice. Occasionally, parents report behavior changes in children, though this side effect is very rare. If this happens, the type of inhaled steroid is changed or the dose is adjusted to improve these behav- ioral concerns. Less commonly seen is a possible delay in linear growth (height). Thrush, also called candidiasis, is a


yeast or fungal infection in the mouth. Thrush is rarely seen in children who use low-dose inhaled corticosteroids. To help prevent thrush, have your child:


* Use a spacer (a tube that holds the


medicine between the inhaler and the mouth) with the inhaler. This helps the medicine get into the lungs with less inside the mouth.


* Rinse with water after using an inhaled corticosteroid.


Throat irritation with hoarseness of


voice occurs more often with dry powder inhalers but has been seen with metered dose inhalers. This symptom can worsen if your child has a cold and is coughing. To


48


help prevent throat irritation and hoarseness:


* Make sure your child is rinsing after using an inhaled corticosteroid.


* Use a spacer when using a metered dose inhaler containing an inhaled corti-


costeroid.


* If your child is using a dry powder inhaler, ask your provider if it can be


changed to a metered dose inhaler. A delay in linear growth or height is a common concern among parents when their child is prescribed an inhaled corticosteroid. This concern has been researched in several long-term asthma studies:


* At low doses, the risk of a height delay is unlikely. It is more likely to be seen at


medium-to-high daily doses.


* This delay in height averages about one centimeter. For most children, their


height catches up when looking at their predicted adult height, though this may not always be the case. Talk to your provider about the best type and dose of inhaled corticosteroid for your child.


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