Rinsing the mouth after each use can also decrease the risk of thrush. Inhaled steroids are the most potent available anti-inflammatory drugs available for the treatment of asthma besides oral steroids. They are excellent medications for the long term management and control of moderate to severe asthma. Because of the possibility of systemic absorption of inhaled steroids, patients treated with these drugs should be observed carefully for any evidence of systemic steroid effects including suppression of growth in children. The degree to which inhaled steroids suppress gowth, if at all, is currently under study.
Steroids also blunt the immune response.
While there are no reports of serious problems with infection in children on the sprays, caution is advised if susceptible children on these sprays are exposed to chicken pox or measles. Because of all these cautions, inhaled steroids are generally not first line drugs. They are reserved for more severe asthma. Generally, cromolyn or nedocromil should be tried first. Inhaled steroids are much preferred over systemic steroids for management of asthma, so in situations where children end up taking oral steroids frequently for management of asthma, using the steroid spray to maintain control after discontinuing the oral steroid is an excellent idea.