Cortisone shock therapy

In cortisone shock therapy, very high doses of cortisone are applied for a short period of time in the acute phase of a disease in order to achieve rapid relief of symptoms. The cortisone dose is then reduced relatively quickly to a dose that corresponds approximately to the Cushing’s threshold. Such a cortisone shock therapy usually leads to a relatively rapid success of the therapy. In bronchial asthma, cortisone shock therapy plays only a very minor role. It is only used – if at all – in stage 5 of asthma therapy if all other measures have not achieved sufficient relief.

What is the difference between tablets containing cortisone and sprays?

Since the bronchial tubes, i.e. part of the airways, are affected in asthma, cortisone preparations are used almost exclusively by inhalation, i.e. as a spray. Only in stage 5, i.e. so to speak the maximum stage of asthma therapy, when all other measures do not achieve sufficient asthma control, cortisone preparations can also be taken in tablet form.

The effect is similar, the cortisone preparations have an anti-inflammatory effect both in inhalation and in tablet form. However, while the spray mainly acts on the bronchial mucosa due to the way it is applied, the tablets act throughout the body. This is unintentional and increases the risk of numerous side effects and Cushing’s disease. For this reason, inhaled cortisone therapy is in most cases preferable to therapy with tablets in bronchial asthma. – Cortisone spray

Cortisone tablet

Side effects

Used correctly in the recommended dosages, glucocorticoids (cortisone) administered by inhalation (inhaled) rarely have systemic side effects and have little influence on the body’s own cortisone production. Under certain circumstances, however, local side effects may occur such as dry mouth, hoarseness, difficulty swallowing and pharyngitis. In connection with inhaled glucocorticoid therapy, fungal infections of the mouth and throat occur more frequently.

After application, residues of the active substance remain in the mouth and throat area and thus promote such infections. Should a fungal infection nevertheless occur, it can usually be treated very effectively with antimycotics (drugs against fungi, e.g. nystatin). The swallowing of remaining active substance residues in the mouth and throat area is no cause for concern.

Glucocorticoids intended for inhalation are inactivated and excreted in the digestive tract. With long-term use of inhaled glucocorticoids, the probability of systemic side effects is much lower than with cortisone tablets. However, a residual risk always remains.

It is therefore advisable to check the growth of children who are dependent on long-term use of cortisone sprays. Women after the menopause should have their bone density (see osteoporosis) checked at intervals. However, a fungal infection in the mouth and throat can be effectively prevented by inhaling your medication directly before eating or by rinsing the mouth or brushing the teeth after taking it.