Inhaled steroids are also called "controllers." A "controller" is a medication that is taken regularly and will prevent and control asthma symptoms. There are several types of controller medications. Inhaled steroids are one category, and are also referred to as corticosteroid inhalers, and anti-inflammatory inhalers.

Remember asthma is made up of three characteristics:

• Constriction (tightening or narrowing)
• Swelling (inflammation of lung tissue)
• Increased mucus in the airways

An inhaled steroid works be decreasing the swelling in the lung tissue, and over time will also relieve constriction and excess sputum. Until recently, inflammation or swelling within the lungs was left untreated. This changed when research revealed that swollen lung tissue over time often developed scarring. This scarring left the lungs irreversibly and "permanently damaged." Treating the swelling with inhaled steroids is simple and effective and can prevent scarring, and most importantly prevents a loss of lung function.

This medicine does not give immediate relief. This medicine does not give immediate relief. It will take one to two weeks before these inhalers can have their full effect. They need time to build up within the lining of the lungs. If the medication is stopped it will again need time to build up. Therefore these inhalers must be used daily even if symptoms are not present. Patients often complain that they have tried these inhalers before and they did not work. When discussing this with the patient the problem is usually:

• They were using too low of a dose or dosing incorrectly. Talk to your physician to make sure you are using your inhaler correctly.
• Their prescription called for use four times a day. This is a difficult task and most steroid inhalers can be changed to twice daily dosing. For example, if a patient is prescribed steroid inhaler 2 puffs four times a day, they can usually take 4 puffs, twice a day. If you are having difficulty taking your controller inhaler four times a day ask your physician about twice daily dosing.
• They thought the medication would give quick relief and so stopped using it when it did not work right away. You will still need your reliever inhaler - always carry your reliever inhaler with you.

These inhalers are steroids but do not have the side effects of "steroid pills." They do not make muscles bigger and don't cause weight gain. The side effect seen most often, but unusual, is mouth sores (thrush) and can be prevented by rinsing and spitting after each use or by using a spacer.

Most Commonly Reported Side Effects

Mouth sores (thrush), hoarseness, and sore throat.

Examples of Inhaled Steroid Medications:

Vanceril

Vanceril DS

Beclovent

Aerobid

Aerobid M

PulmicortTurbuhaler

Flovent Rotodisk

Flovent

Azmacort