From the Guidelines
The nurse should tell the parent that growth may be slowed while the child is taking inhaled glucocorticoids, but the eventual adult height will not be reduced (option A). Inhaled glucocorticoids, commonly prescribed for conditions like asthma, can temporarily slow growth velocity in children during treatment. This effect is typically most pronounced during the first year of therapy and is dose-dependent 1. However, research has shown that this temporary growth suppression does not generally affect final adult height. The body compensates for this slowdown once the medication is reduced or discontinued, allowing for catch-up growth 1. This temporary effect should be weighed against the important benefits of controlling asthma symptoms, as poorly controlled asthma itself can negatively impact growth. Parents should discuss any concerns with their healthcare provider, who can monitor the child's growth and adjust medication dosages if necessary to minimize potential side effects while maintaining effective symptom control. Some key points to consider include:
- The use of inhaled corticosteroids at recommended doses does not have frequent, clinically significant, or irreversible effects on growth outcomes 1
- Most children treated with inhaled corticosteroids achieve their predicted adult heights 1
- Asthma itself can delay growth and puberty, but catch-up growth occurs 1
- Short-term reductions in growth rate have been shown with high doses of inhaled steroids, but these cannot be extrapolated to long-term effects 1
From the FDA Drug Label
Pediatric patients who are treated with corticosteroids by any route, including systemically administered corticosteroids, may experience a decrease in their growth velocity. Growth velocity may therefore be a more sensitive indicator of systemic corticosteroid exposure in pediatric patients than some commonly used tests of HPA axis function The linear growth of 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.
The nurse will tell the parent that growth may be slowed in children using inhaled glucocorticoids.
- The growth velocity of pediatric patients may decrease, but the label does not explicitly state the effect on eventual adult height.
- The nurse should monitor the linear growth of pediatric patients and weigh the potential growth effects against the clinical benefits of the treatment 2.
From the Research
Growth Suppression in Children due to Inhaled Glucocorticoids
- The provided studies do not directly address the question of growth suppression in children resulting from inhaled glucocorticoids.
- However, it is known that glucocorticoids can have various effects on the body, including regulating physiological processes and influencing the response to stress 3, 4, 5, 6, 7.
- The effects of glucocorticoids on growth and development are not explicitly mentioned in the provided studies, but it is clear that glucocorticoids play a crucial role in regulating essential functions, including energy homeostasis, immunomodulation, and maintenance of circadian rhythm 6.
- Some studies suggest that prolonged glucocorticoid exposure can result in metabolic side effects, such as central obesity, insulin resistance, and osteoporosis 6, but the impact on growth in children is not specified.
- Without direct evidence from the provided studies, it is difficult to determine the correct answer to the question, but option A "Growth may be slowed but the eventual adult height will not be reduced" is a commonly cited statement in the context of inhaled glucocorticoid use in children, although it is not supported by the provided references 3, 4, 5, 6, 7.