Oral steroids enter the bloodstream to get to the lungs, so they can cause these and other systemic effects, particularly if used frequently or for long periods of time. Other effects include cataracts, increased blood sugar, lack of blood supply to some bones and suppression of the body's own production of steroids needed during stress. Since inhaled steroids reduce the amount of oral steroids that may be needed for asthma, they may be safer than just using as needed mediation in all but the mildest forms of asthma. If your child is given many courses of oral steroids, careful monitoring for some of these side effects may be necessary.
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Nebulisers are machines that turn the liquid form of your short-acting bronchodilator medicines into a fine mist, like an aerosol. You breathe this in with a face mask or a mouthpiece. Nebulisers are no more effective than normal inhalers. However, they are extremely useful in people who are very tired (fatigued) with their breathing, or in people who are very breathless. Nebulisers are used mainly in hospital for severe attacks of asthma when large doses of inhaled medicines are needed. They are used less commonly than in the past, as modern spacer devices are usually just as good as nebulisers for giving large doses of inhaled medicines. You do not need any co-ordination to use a nebuliser - you just breathe in and out, and you will breathe in the medicine.