Oral or IV Prednisolone in the Treatment of COPD Exacerbations

The impact of pharmacy mediated conversion from intravenous to oral corticosteroids in patients with an exacerbation of chronic obstructive pulmonary disease

“…The average daily dose and duration of IV corticosteroids observed, approximately 170 mg methylprednisolone for almost 3 days, is inconsistent with the current treatment recommendations for moderate dose oral corticosteroids [8, [10][11][12][13]. Moreover, it was noted that our facility favors the use of IV methylprednisolone over dexamethasone as it was shown in the post intervention group compared with control group.…”

“…Nevertheless, the use of oral prednisone should be encouraged in patients with acute exacerbations of COPD consistent with current evidence and guidelines recommendations [8][9][10][11][12]. As a result of this analysis, local treatment practices involving high dose IV corticosteroids as a standard initial therapy should be reevaluated.…”

“…Based on current literature, the use of oral corticosteroids in patients with COPD exacerbations is as effective as IV administration, and would be preferred in cases where patients can safely absorb oral medications. Low dose oral corticosteroids are not associated with worse outcomes than high dose IV treatment, and the short course treatment of systemic corticosteroids is not inferior to long course treatment [10][11][12][13]. Thus, the treatment with oral corticosteroids for a short period of time seems to be a reasonable approach in treating patients with an acute exacerbation of COPD.…”

Contemporary Approaches to the Chronic Obstructive Pulmonary Disease Exacerbations in Emergency Department

“…Tedavi süresi, alevlenmenin şiddeti ve tedaviye verilen yanıta göre değişmek ile birlikte, tam doz tedavi 5-14 gün boyunca verilmektedir. 29,30 Alevlenme tedavisinde oral kortikosteroidler yerine uygulanabilecek bir seçenek de (daha pahalı olmakla birlikte) nebülize budesoniddir. Ülkemi-zde; beklometazon, budesonid, flutikazon ve bunların β2 agonistlerle kombine preparatları mevcut tur.…”

Therapy for Exacerbations of Chronic Obstructive Pulmonary Disease

“…Оптимальной ингаляционной техникой доставки препарата при обо-стрении ХОБЛ являются небулайзеры, так как их исполь-зование не зависит от возможностей ингаляционного усилия больного. Применение системных ГКС при обо-стрении ХОБЛ позволяет сократить время наступления ремиссии, сопровождается улучшением вентиляцион-ной функции легких и уменьшением гипоксемии [1,19]. Кроме того, ГКС уменьшают риск раннего рецидива и неудачи лечения, позволяют снизить длительность пре-бывания в стационаре.…”