Higher doses of inhaled beclomethasone (more than 1000 mcg/day) may result in more absorption into the body. This may decrease bone formation and increase bone breakdown (resorption), resulting in weak bones and a risk of fractures . Even higher doses (more than 1500 mcg/day in adults and 400 mcg/day in children) may suppress the adrenal glands and impair their ability to make natural glucocorticoid. Patients with such suppression (which can be identified by testing) need increased amounts of glucocorticoid orally or by the intravenous route during periods of high physical stress since higher amounts of glucocorticoids are needed by the body to fight physical stress.
Nebulisers are machines that turn the liquid form of your short-acting bronchodilator medicines into a fine mist, like an aerosol. You breathe this in with a face mask or a mouthpiece. Nebulisers are no more effective than normal inhalers. However, they are extremely useful in people who are very tired (fatigued) with their breathing, or in people who are very breathless. Nebulisers are used mainly in hospital for severe attacks of asthma when large doses of inhaled medicines are needed. They are used less commonly than in the past, as modern spacer devices are usually just as good as nebulisers for giving large doses of inhaled medicines. You do not need any co-ordination to use a nebuliser - you just breathe in and out, and you will breathe in the medicine.