Cold->Asthma->Nebulizer-> Beastly Son :-(

Updated on April 06, 2013
M.P. asks from De Pere, WI
14 answers

For the past year or so, it has been our experience that every time our son gets a cold, he gets "reactive airway disease" symptoms, which our Allergy/Asthma dr. is now calling "Viral Induced Asthma". First we were using albuterol nebulizer, but using it enough that Dr. said we should have something else so he prescribed an inhaled steroid (Pulmicort) (also given via nebulizer).

Last cold, beginning of March?, we noticed a difference in his behavior, made mental note. Seemed to ease up after he was feeling better. This time, we started meds yesterday (instructions are to start as soon as we see cold symptoms because his history is to go downhill fast once cold gets in his system), and today I got a report from his preschool/day care teacher that he was abnormally aggressive. He was pinching, pushing, wouldn't keep his hands to himself, etc. and that she's "never seen him like that!!"

I know these behaviors are SO normal for his age (he is 3 in June). But the degree that we see them while he is on these meds is NOT normal for him. Just wondering if others have experienced this? And if there was anything that helped get your through the 7-10 days of cold symptoms with a toddler who was extra beastly? :-/


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So What Happened?

@ Lola - I just checked his imunization record - he has not received the pneumovax at all. ?? Not sure if he has gotten something comparable? But that is an interesting thing to know. Thanks. His Dr. did say the mood could be a result of meds and that other "preventive" meds have a tendency to cause undesirable behavior side just wondering how others experience is and how they handle it.

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answers from Los Angeles on

It's the meds. I say this with experience as my just about 4 y/o guy was diagnosed in November and I notice this each time we need to use Albuterol or Prednisone and another I forget. Let his teacher know so she's aware (no, it doesn't excuse the behavior and he still needs proper discipline but at least she will know why especially if he becomes raging.) My guy's teacher understood right away, her daughter has asthma, too.

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answers from Miami on

Oh yeah. Don't let ANYONE tell you that these medications aren't a reason for behavioral and personality changes. Little beaties, absolutely!

My son had RAD too, mom. He threw up bottles FULL of mucous and wheezed. We had to give him albuterol in liquid form, and steroids. The steroids are what made him awful. Just awful. Reminded me of when he was cutting big molars before I realized it and gave him pain meds. But Tylenol wouldn't help this.

We got lucky. His RAD didn't turn into asthma. He did have croup and that always warranted a nebulizer. The last time he had croup was when he was 7 years old. Old ENOUGH to understand that his behavior was off. I gave him his neb in the morning and we went on a trip. He was so bad in front of our friends. The other mom is a doctor and she knew him. She told me that his neb could certainly be the cause. That night in the hotel, I told him that it was time for another treatment, and he started crying and asked me not to give it to him. He told me that it made him feel awful inside himself.

Poor guy. We got through it and thankfully no more croup after that.

I just want you to understand that at your son's age, he cannot control this. Heck, my 7 year old couldn't. Ask your doc if there is a different med you could try.

Good luck!

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answers from Portland on

I've had asthma since childhood, and have been on various meds over the decades. I had to give up an albuterol inhaler. It made me feel tense, jumpy, angry, my heart raced, and it was impossible to sleep, and these symptoms became worse over the couple of years I used it.

Once I switched to Pulmicort, I did much better all around. But every person will probably have very particular reactions to any drug or medical treatment. Cortisone causes brain/personality changes in some people, but the Pulmicort is incredibly tiny doses that, according to my doc, don't really migrate far from the lung surfaces, so are unlikely to cause "cortisone psychosis."

Because asthma is potentially very serious, it's probably a good idea to keep the albuterol on hand for emergencies, but minimize the use if possible.

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answers from Honolulu on

I have Asthma and since childhood.

Yes, inhalers can cause these behaviors in some individuals.
I don't get this way, but a child might.
They are tinier.
Make sure, that the prescribed amount of inhales, is accurate.
Do not use too much or too little.
And a person and also overdose on inhalers too.
So you need to follow directions, accurately.

Now, also know that, there are MANY types & brands of inhaler medicines. Not only the Albuterol. So maybe ask the Doc about that.
Some are 'rescue' inhalers and others are 'maintenance' inhalers etc. For example.
I personally take "Xopenex." And Albuterol types.
But that is me. My Mom on the other hand, does not like Xopenex. It makes her moody. For example.

Now, Pulmicort or inhaled steroids... are used to dramatically decrease the acute symptoms because it is a steroid. Hence, it is used for acute stages. And these can perhaps, also affect moods/behavior. But, if there is acute constriction of the airways, it does need to be used.
Asthma means, the person cannot breathe nor sufficiently, because the airways are constricted. Narrowed. Inflamed, hence constricted. And thus, there is not enough oxygen, in a person's system or lungs or blood.

Sure he is 3 years old and this is not an easy age.
BUT if and since, the medicine is affecting him.... you cannot expect him to be able to... control ALL his impulses or moods. Because it is medicine induced.
TELL the school.
Or, keep him home if you can, until he is not sick.

Again, there are many other types of inhalers. Find the right fit. Ask the Doc.
Also, make SURE he has all his vaccinations.
And the Pertussis one etc.
Because, anyone with Asthma.... needs to be, vaccinated.
They can also get Pneumonia.
I have gotten the Pneumonia vaccine, and I ALWAYS get the Flu shot.
Anyone with compromised lung issues, needs to be vaccinated appropriately. Asthma, is serious.

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answers from Augusta on

well it's a stimulant. it's like giving him coffee.
For my daughter shes' got ADHD , I see an improvement in her behavior because of the same fact. It's a stimulant just like her ADHD medication.

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answers from St. Louis on

for me, with my daycare, the kids get jittery/crazy crazy & then crash within the hour.

for myself, when I do the inhaler, I am soooo thankful that the episode is over...that I just feel relief!

& if I'm on antibiotics, then watch out! I'm meaner than mean, & bitchy... short-patience to boot. Yikes!

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answers from Boca Raton on

my daughter used the nebulizer (every winter) since she was 3. her prescribed meds were albuterol and pulmicort (steroid). she never expressed any of the symptoms you are describing. he may be feeling sick or under the weather if he is acting out but doubt it's related to the meds.
my only advice is have his immunity testing. yes sounds weird but a mom here had suggested to me 2 years ago i do for my daughter. we did it this year and turns out she never developed immunity after getting pneumovax shot (to built upper respiratory infection immunity). they gave her a booster shot in december and the kid has gone through 3 colds now without any of the breathing problems, wheezing, sinus infections, ear she used to before. knock on wood, she is getting over the colds like a champ now. so consider doing that through an infectious disease specialist.
EDIT: just read your post note: ask your pediatrician when is he supposed to get that shot, see if he can get it sooner or maybe it was skipped? but anyway, i cannot describe how thrilled we are after this booster she got. my daughter lived on nebulizer for years and with new york winters she'd use it from november til april and then some. she had 3 colds since december and we did not have to go to the pediatrician once, i only upped her vit c dosage, had her drink plenty of tea with honey, the usual stuff. no nebulizer no antibiotics. good luck

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answers from Dallas on

Yes, its essentially "roid rage" from the steroids... very commonly a parents worst fear with treating asthma like symptoms! I know I dread it! Just remind yourself that it's the meds and keep him and others safe. Sorry you're dealing with this :(

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answers from Spokane on

ok with pulmicort your supposed to give it everyday. its a prevenative. my daughter takes this. it takes a week to fully see results. i would ask for a standing order so you can get the pulmicort as for the behavior changes maybe give it to him at night and not in the morning. it takes them a while to adjust to the steriods (they are uppers).



answers from San Francisco on

My son has asthma and it's mostly illness induced. We give him a pulmicort (budesonide is the generic) treatment once a day during the cold/flu season. If he shows signs of getting sick, we bump it up to 2-3 times a day. It's given via a nebulizer.

We also have a fast acting albuterol type medicine both in an inhaler form and in a nebulizer form. The inhaler form is for when we are out and about. In general though, while he is on pulmicort, we haven't had much of a need for the albuterol.

In my personal asthma experience, the albuterol is the one that is more likely to make you jumpy, shaky, or heart racing, than the pulmicort.

With my son, we haven't experienced any change in his behavior when he is on the meds. My son is 4 and has been on nebulizer treatments since he was 2ish.

If you are concerned, you could check with the doctor if there are alternative nebulizer medicines for pulmicort (a preventative/maintenance medication).

I'm not aware of any in nebulizer form, but I do know there are variations for albuterol (a fast acting/rescue medication) in nebulizer form. There is the generic albuterol that may be given under different brands. There is also Xopenex (levalbuterol) that supposedly has gentler side effects. I haven't been able to confirm or deny that claim though.

I don't know what kind of doctor you have seen, but if you haven't seen an pediatric asthma specialist, it might be worth checking in with one. You could describe your concerns and ask if there are different medicines you could try. The specialist is more likely to know about the various types of treatment than a general pediatrician would.

For what it's worth, my sons are twins and the one that doesn't have asthma is the one we have more trouble with respect to aggressive behavior. The one that takes the inhaler is more laid back and I haven't noticed him suddenly get more aggressive after taking the medication.

It could be your son is just not feeling well and acting out as a result.



answers from Los Angeles on

My son did not have any sort of behavioral changes when he used Pulmicort through a nebulizer. For 2 or 3 years, we used it almost daily from November - March or April to protect him during flu season. His behavior was the same as during the months we didn't use it.

Since the doctor seems to think it's a normal reaction, the best advice I can think to give is to change the time of day you're giving it to him. If you are currently doing it in the morning, try switching to the evening. Maybe the worst of the effects will occur during his sleeping hours and it won't affect him as much when he's awake. We almost always gave my son his treatments after dinner.

Also, even though the doctor says other medications could have the same effect, it's possible that your son won't experience the same reaction with a different med. Knowing Plumicort is a problem, it certainly can't hurt to try a different one for a couple of weeks and see what happens.

Finally, make sure you talk to the teacher about it if you didn't already. Let her know that it's likely a side effect of the medication and you're working with his doctor to resolve the issue.



answers from Minneapolis on

My son responded the same way to steroids ... Even when taken nasally.



answers from New York on

Probably because he is not feeling like himself. Inhaled albuterol might make him jittery for about 3 minutes. Now, I the days before news OMG.
Oral albuterol made kids like wild,en!!!! My daughter was in hospital on it 32 years ago n did not sleep for three days. Not so with inhaled. Thank goodness.



answers from Dallas on

Yep, it can make some kids that way. Most will just get jittery and not have anything on an inhaled steroid, but then there are others who are just like you said. Growing out of it is about your only hope. You might try extra snacks in case his blood sugar is effected.

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