what is the normal duration of treatment for asthma using oral prednisolone? when to tapper? tq.
Announcement
Collapse
No announcement yet.
duration of oral prednisolone use in asthma
Collapse
X
-
30mg daily for a week is a pretty standard dose. This is what the BNF says about tapering of steroid doses:
--------
The CSM has recommended that gradual withdrawal of systemic corticosteroids should be considered in those whose disease is unlikely to relapse and have
* recently received repeated courses (particularly if taken for longer than 3 weeks)
* taken a short course within 1 year of stopping long-term therapy
* other possible causes of adrenal suppression
* received more than 40 mg daily prednisolone (or equivalent)
* been given repeat doses in the evening
* received more than 3 weeks’ treatment
Systemic corticosteroids may be stopped abruptly in those whose disease is unlikely to relapse and who have received treatment for 3 weeks or less and who are not included in the patient groups described above.
During corticosteroid withdrawal the dose may be reduced rapidly down to physiological doses (equivalent to prednisolone 7.5 mg daily) and then reduced more slowly. Assessment of the disease may be needed during withdrawal to ensure that relapse does not occur.
------------
So most patients receiving prednisolone for an exacerbation of asthma are not going to need to have their dose gradually reduced.
-
Seems a bit of a high dose, and for a long period. Is it definitely for asthma? Dose tapering is not normally needed if the patient is on inhaled steroids, as inhaled steroids aren't normally absorbed enough to supress cortisol secretion. However high doses of Flixotide, for example (i.e 2mg/day), may affect endogenous cortisol secretion.
Comment
-
Beyond High Dose Prednisolone
Originally posted by Steve G View PostSeems a bit of a high dose, and for a long period. Is it definitely for asthma? Dose tapering is not normally needed if the patient is on inhaled steroids, as inhaled steroids aren't normally absorbed enough to supress cortisol secretion. However high doses of Flixotide, for example (i.e 2mg/day), may affect endogenous cortisol secretion.
High dose treatment of corticosteriods has been used for other diseases, but it generally causes more problems that it cures.
As Steve has commented it looks to high and too long for Asthma.
If the treatment is for a long period of time the patient will be well on their way to developing cushings syndrome. Their immune system will be suppressed so they could pick up infections easily, anything going around the community, such as chickenpox, and they would experience delayed wound healing. Make sure that they don't get into the repeat prescription cycle or the long term effects would not be pleasant.47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
2018 AD : Modern Man : I shopped, I clicked, I collected.
How times change.
If you find you have read something that has upset or offended you an anyway please unread it at once.
Comment
-
Prednisolone duration/dose
Has anyone read about an on going case against one of the big multi-nationals , an American patient is suing both her doctor and the chemist (here in England ) for braech in the duty of care . The pharmacist dispensed the steroid according to the GPs instructions but failed to make any appropriate interventions ( the patient got a very high dose hence is now battling with cushings syndrome) she is suing for ÂŁ2m at the high court
.. don't know what to say ..all I can say is that as pharmacists we are not just pill counting professionals we need to be mega careful.. I have no doubt that you guys are anywayKemzo the pharmacist forumly known as kemzero
Comment
-
Originally posted by kemzero View PostThe pharmacist dispensed the steroid according to the GPs instructions but failed to make any appropriate interventions ( the patient got a very high dose hence is now battling with cushings syndrome)
she is suing for ÂŁ2m at the high court
.. don't know what to say ..all I can say is that as pharmacists we are not just pill counting professionals we need to be mega careful.. I have no doubt that you guys are anywayLinnear MRPharmS
Foetal Alcohol Spectrum Disorder: The biggest cause of brain damage and 100% preventable.
In pregnancy: 1 fag is not safe, 1 x-ray is not safe and 1 drink is not safe.
For handy pharmacy links try
pharmacistance.co.uk
If you like my posts or letters in the journal try my books!
eloquent-e-tales
Comment
-
Originally posted by Linnear View PostAs far as I could see the pharmacist had no reason to intervene. The dose was not excessive. The problem occurred in the US when the Dr prescribed the dose from the UK dispensing label!Ze genuine Article, present & perfect!
Comment
-
Originally posted by Zoggite View Post...and from what I understand, the US doctor didn't just blindly repeat the Rx once, but repeatedly over a number of months, which is what really caused the Cushing effect...
Jeff
Comment
-
Watch it! I got into trouble for suggesting that patients who did nothing to improve their health shouldn't be treated on the NHS now you're saying that Drs shouldn't treat stupid yank holidaymakers!Linnear MRPharmS
Foetal Alcohol Spectrum Disorder: The biggest cause of brain damage and 100% preventable.
In pregnancy: 1 fag is not safe, 1 x-ray is not safe and 1 drink is not safe.
For handy pharmacy links try
pharmacistance.co.uk
If you like my posts or letters in the journal try my books!
eloquent-e-tales
Comment
-
Originally posted by Linnear View PostWatch it! I got into trouble for suggesting that patients who did nothing to improve their health shouldn't be treated on the NHS now you're saying that Drs shouldn't treat stupid yank holidaymakers!Ze genuine Article, present & perfect!
Comment
-
Only kidding Jeff!
I think you're right though. It's sad isn't it? Everyone has to think twice before helping anyone.Linnear MRPharmS
Foetal Alcohol Spectrum Disorder: The biggest cause of brain damage and 100% preventable.
In pregnancy: 1 fag is not safe, 1 x-ray is not safe and 1 drink is not safe.
For handy pharmacy links try
pharmacistance.co.uk
If you like my posts or letters in the journal try my books!
eloquent-e-tales
Comment
Comment