Note when using Corticosteroids in children

The article was professionally consulted by Pharmacist Ngo Thi Thu Thuy and pharmacist Nguyen Hoang Phuong Khanh - Faculty of Pharmacy - Vinmec Central Park International General Hospital

Corticosteroids or Steroids or Corticosteroids are hormones produced by the adrenal glands (two small glands located above the kidneys) including 3 groups: glucocorticoids, mineralocorticoids and androgenic sex hormones.

1.1 Systemic administration
Congenital adrenal hyperplasia 1.2 Treatment of systemic symptoms
Acute:
Allergic reactions, anaphylaxis bronchial asthma Vomiting and nausea (after radiation therapy in cancer treatment) , after surgery...) Chronic
Rheumatoid arthritis Systemic lupus erythematosus Chronic inflammatory diseases : Bronchial asthma.... Prevention Organ transplantation (prevention of transplant rejection) Indications for topical use in dermatology including: Skin diseases such as psoriasis, eczema, atopic dermatitis, psoriasis, eczema, atopic dermatitis....
Allergic reactions, anaphylaxis Bronchial asthma Rheumatoid arthritis Lupus rash Systemic redness Congenital adrenal hyperplasia

Corticosteroids are prescribed drugs that are quite common in children, but not because of that, they are absolutely safe. Side effects of corticosteroids depend on the type of drug, dose, duration, route of administration, amount, and location if used topically. Improper use of corticosteroids can bring about many side effects, especially in children. Children and infants such as:
Osteoporosis (Osteoporosis) soft bones are fragile, more severe can cause bone necrosis.
Cushing's syndrome: This side effect appears when taking drugs with high doses for a long time, especially when taking systemic drugs (oral, injecting), with typical symptoms:
Rapid, unbalanced weight gain , usually round face like the moon, more fat on the abdomen, back of the neck and neck, while the thighs and arms shrink, disproportionately Skin changes: Skin becomes thinner and flushed. Face has more acne, belly and thighs have more stretch marks. Other problems: Menstrual irregularities can occur in girls. Adrenal insufficiency : this is a rather serious unwanted side effect. Children with adrenal insufficiency often have signs of fatigue, weakness, nausea and vomiting, and low blood pressure, which are nonspecific and can be confused with the underlying disease/condition. Impaired resistance: Improperly used corticosteroids with high doses, for a long time make children at increased risk of infection, susceptible to bacterial infections, especially with common pathogens caused by bacteria, viruses and fungi. eg pneumonia, chickenpox, tuberculosis..) Using topical corticosteroids: Causes thinning of the skin (Atrophy), varicose veins telangiectasias, stretch marks (striae), occurs when abused or used not as prescribed by a doctor when using topical corticosteroids in the treatment of atopic dermatitis, eczema. Other side effects: Growth retardation; Grow more acne, hirsutism; Cataracts, glaucoma; Mental health decline, children may show insomnia, anger easily, episodes of excitement or depression...
With the common side effects mentioned above, children should not use corticosteroids. including children with tuberculosis, epilepsy, diabetes, osteoporosis, cataracts, glaucoma, high blood pressure, ...
Parents need to take their children to a health facility immediately when they have them. the following symptoms:
Fever, chills Convulsions Chest tightness Shortness of breath, shortness of breath, or wheezing Feeling of thirst Frequent urination, burning sensation when urinating Muscle aches, weakness Swollen hands and feet Stomach pain Black or bright red bloody stools Vomiting of fresh blood or bruises like coffee grounds Irregular menstrual cycles in girls Blood sugar not well controlled in children with diabetes

Like all other drugs, corticosteroids need to be used under the guidance of doctors, especially specialists and pharmacists. Parents are not allowed to arbitrarily use, increase or decrease the dose or prolong the time of drug use. For individual cases requiring high doses of drugs, pediatric patients should be under the supervision and monitoring of doctors to promptly detect and handle side effects. Another important point to note that should be emphasized is that absolutely do not suddenly stop using the drug because of severe and life-threatening complications of acute adrenal insufficiency, even if the drug is used at very high doses. short. The dose reduction should be done slowly, according to the treatment regimen and the guidance of a specialist.

Some notes to know when using corticosteroids:
Take the drug at a fixed time of the day, preferably in the morning if the drug is only taken once a day. Give your child corticosteroids with food to avoid stomach upset. Always remember to inform the doctor that the child is using corticosteroids if unfortunately the child has to be hospitalized for treatment or surgery. Osteoporosis prevention, weight control: Your child should have a low-fat, low-salt diet, limit red meat and saturated fat, and encourage eating plenty of fresh fruits, vegetables, water, and fat-free dairy. Add vitamin D and calcium in your diet. There are some vaccines that should not be given while taking them. If necessary, before deciding to vaccinate should discuss with the treating doctor. Avoid contact with sick people, avoid crowded places. Clean hands. Parents should take their child to see a doctor right away if the side effects of the medication repeat or worsen.