Systemic Steroid Therapy

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Chapter: Essential pharmacology : Drugs for Cough and Bronchial Asthma

Systemic steroid therapy is resorted to in asthma under the following two situations:


SYSTEMIC STEROID THERAPY

 

Systemic steroid therapy is resorted to in asthma under the following two situations:

 

Severe Chronic Asthmanot controlled by bronchodilators and inhaled steroids, or when there are frequent recurrences of increasing severity; start with prednisolone 20–60 mg (or equivalent) daily; attempt dose reduction after 1–2 weeks of good control and finally try shifting the patient onto an inhaled steroid. Only few patients require long term oral steroids—in them dose should be kept at minimum.

 

In patients requiring long term glucocorticoid therapy, alternative treatment with immunosuppressants like methotrexate (low dose) or cyclosporine has been tried.

 

Status Asthmaticus/Acute Asthma Exacerbation: Asthma attack not responding to intensive bronchodilator therapy: start with high dose of a rapidly acting i.v. glucocorticoid which generally acts in 6–24 hours—shift to oral therapy for 5–7 days and then discontinue abruptly or taper rapidly.

 

COPD A short course (1–3 week) of oral glucocorticoid may benefit some patients of COPD during an exacerbation.

 

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