The adverse effects of corticosteroids in pediatric patients are similar to those in adults (see ADVERSE REACTIONS ). Like adults, pediatric patients should be carefully observed with frequent measurements of blood pressure, weight, height, intraocular pressure, and clinical evaluation for the presence of infection, psychosocial disturbances, thromboembolism, peptic ulcers, cataracts, and osteoporosis. Pediatric patients who are treated with corticosteroids by any route, including systemically administered corticosteroids, may experience a decrease in their growth velocity. This negative impact of corticosteroids on growth has been observed at low systemic doses and in the absence of laboratory evidence of HPA axis suppression (., cosyntropen stimulation and basal cortisol plasma levels). Growth velocity may therefore be a more sensitive indicator of systemic corticosteroid exposure in pediatric patients treated with corticosteroids should be monitored, and the potential growth effects of prolonged treatment should be weighed against clinical benefits obtained and the availability of treatment alternatives. In order to minimize the potential growth effects of corticosteroids, pediatric patients should be titrated to the lowest effective dose.
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.