steroids :: essays research papers

Q. I have patients previously diagnosed as Asthma who are now classified as COPD. Should I adjudge them on inhaled steroids?A. If you have a strong suspicion that your patient has COPD quite an than asthma (smoking history, progressive shortness ofbreath), then you should slowly reduce the venereal infection of inhaled steroids (over several months - e.g. 25% reduction every 2-3 months). In most patients with COPD you leave behind be able to withdraw the inhaled steroid tout ensemble, without any increase in symptoms or change in lung assist.Q. What is a recommended steroid exertion for COPD?A. The most frequently utilize regime for a steroid trial is to give oral prednisolone (40mg daily in a single morning dose) for 2 weeks. It is outmatch to make measurements of peak expiratory flow (PEF) twice a daytime for 2 weeks before starting oral steroids in order to depict a baseline value and then during the treatment period. FEV, should be measured at the beginning and end o f the baseline period and after the inhaled steroids. A steroid trial is considered positive if FEV, or mean PEF increase by more than15%, when a diagnosis of asthma is made. It is important to remember that few patients will have asthma and COPD atthe same time.Q. What is the role, if any, for oral steroids in COPD?A. Oral steroids are used in a formal trial of steroids and whitethorn be useful in acute exacerbations of COPD. They should not be used as a maintenance treatment because of the side set up of long-term steroid therapy.Q. With a newly diagnosed COPD patient should I make steroid therapy, if so how?A. If a patient has COPD with no evidence of answer to oral steroids (negative steroid trial) then inhaled steroids should not be used. It is possible that inhaled steroids may alter the accelerated annual rate of decline in lung function with age.Q. How will I know if a COPD patient is benefiting from steroid therapy?A. The trump out way to determine whether inhaled ster oids are beneficial is to slowly reduce the dose. If FEV, or mean PEF show no deterioration, the inhaled steroid can be completely withdrawn.Q. Will COPD patients need to be on long-term steroid therapy? If so, what some side effects?A. Only patients who have shown a positive rejoinder to oral steroids (steroid trial) should be on inhaled steroids.