Steroid-Dependence
Definition
When corticosteroids are taken as a medication, they can suppress the normal secretion of corticosteroids from the adrenal gland. If the corticosteroid medication is given over a very long time, it may cause the adrenal gland to no longer function effectively. It may take months to years for this gland to recover completely, long after use of a corticosteroid medication has been discontinued. The daily secretion of corticosteroids is essential to remaining healthy, particularly when the body is under physical stress (e.g. severe illness or infection, surgery, acute asthmatic symptoms, or physical trauma). For example, if you become ill and your asthma worsens, the body normally responds to this physical stress by secreting up to 5 to 10 times the usual amount of natural corticosteroids. In addition, the adrenal gland's response to stress is also required for other important body functions.
Under rare circumstances, when your adrenal glands are malfunctioning from long term corticosteroid use, and no supplemental corticosteroids are administered during an asthmatic attack, there is the possibility that a severe, acute flare of asthma may develop which ultimately may lead to a fatality. In view of this risk, if you are "steroid-dependent," you must be given supplemental corticosteroids during asthmatic attacks or during any other major physical stress.
Criteria
The Asthma Center specialists consider you "Steroid Dependent" if you receive corticosteroids in the following manner:
Frequent, short term oral corticosteroid treatment bursts in the past 12 months
Regular use of high dose inhaled corticosteroids in the past 12 months
Regular use of injected long acting corticosteroids
Daily use of oral corticosteroids
Alternate-day oral corticosteroids
Prolonged use of oral corticosteroids in the past year
Medical Implications
If you are "steroid-dependent," you must be given a booster dose of corticosteroids when you become physically stressed with severe infection, surgery, labor and delivery, acute asthmatic episodes, or following physical trauma.
Since you might be brought to a hospital in an unconscious state during an emergency, The Asthma Center specialists advise you to carry a card in your wallet/purse or wear a MedicAlert bracelet which has the following information:
- Identification that you have asthma and are "steroid-dependent"
- List of all current medications and diagnoses
- How the emergency room and/or hospital personnel can reach your treating physician(s) for further information
