Following are answers from allergist Dr. Stanley Fineman to three common questions parents have about steroid use.Q: How do I know whether inhaled corticosteroids are necessary? A: A physician typically determines whether inhaled corticosteroids are the best course of treatment, based on the severity of the patient's asthma.Traditionally, a physician will talk to patients about their history and symptoms (coughing or wheezing), perform a physical exam and testing -- such as lung function -- to get a clearer picture of each patient's individual asthma. By measuring FeNO levels, physicians can better determine if steroids are the appropriate course of treatment and if dosage might need to be increased or decreased. Q: If my child isn't taking his or her medication as directed,will my doctor be able to tell? A: Sometimes, but not always. In general, it is very difficult to measure a patient's adherence to medication because asthma is such a variable disease, meaning symptoms can wax and wane depending upon a patient's exposures to triggers. Studies have shown, however, that FeNO levels can be helpful in determining whether patients have been taking their steroid medication as directed by their physician. Q:How can I talk to my doctor about adjusting my child's dosage? A: The three most important pieces of information that a parent, caregiver or individual should share with their doctor are the types of symptoms that the child has been experiencing, how frequently the child needs to use their bronchodilator inhaler and what sort of physical limitations the asthma symptoms have been causing. If a patient's asthma is under control, a physician may consider reducing the dose. If the asthma is not under control, you might want to adjust medication or treatment recommendations.
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