Oral corticosteroids are used when asthma can't be controlled by other medications. When taken orally for an extended period of time, corticosteroids may cause side effects such as growth suppression, weak bones, weight gain, high blood pressure, cataracts, muscle weakness and swelling or puffiness. The inhaled forms are unlikely to cause these side effects, but may cause throat irritation, thrush and hoarseness. Nonsteroidals, including cromolyn sodium and nedocromil, are anti-inflammatories that are inhaled directly into the lungs in order to prevent the onset of symptoms. They work by protecting the bronchial tubes from environmental irritants or allergens.
Nonsteroidals are safe in most instances with minor side effects.
The available drugs in this class are taken orally, including zafirlukast, which produces few side effects and zileuton, which requires periodic blood tests to monitor for possible effects on the liver. Regular monitoring allows patients to see how well their treatment plan is working. Breathing can be tested by measuring peak flow, the speed at which air can be pushed out of the lungs at any one time. Using a simple device called a peak flow meter, patients should test their peak flow at the same time each day. Results should be recorded daily and shared with a doctor.