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Tapering prednisone in pulmonology

Treatment of a wide variety of diseases and conditions; used principally for glucocorticoid effects as an anti-inflammatory and immunosuppressant agent and for its effects on blood and lymphatic systems in the palliative treatment of various diseases. My first encounter with steroid tapers was likely in medical school, but I most vividly remember writing a number of long (3-6 week) steroid tapers for patients with chronic obstructive pulmonary disease (COPD) in residency. There is no cure for sarcoidosis, but the disease may get better on its own over time.

Tapering prednisone in pulmonology

Tapering prednisone in pulmonology

The literature has established that the use of systemic corticosteroids in COPD exacerbations decreased time to recovery, decreased hypoxemia, and improved FEV1.1,2,3,4 However, the dose and duration of corticosteroids used to treat COPD exacerbations is hy variable and has been widely debated. Sarcoidosis is a systemic granulomatous disease of unknown cause affecting young and middle-aged adults.

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  • What are corticosteroids (‘steroids’) Does the body make steroids? What are some important considerations when your dosage changes?


    Tapering prednisone in pulmonology

    Tapering prednisone in pulmonology

    Tapering prednisone in pulmonology

    Many patients are not as well informed about prescription medications as they ought to be. My favorite patient (long now deceased) was a retired military police officer with end stage COPD with frequent hospitalizations for exacerbations.

    Tapering prednisone in pulmonology

    Previous Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend 30-40mg of oral prednisolone daily for 10-14 days.5 The most recent iteration of the guidelines recommended considering even shorter durations of 5 days based on the findings from the recently published REDUCE trial.6,7 Due to side effects of steroids such as blood glucose elevations, emotional lability, and predisposition to fractures, especially at cumulative doses 1g prednisone or the equivalent,8,9 it is important to limit exposure if possible. APO PROPRANOLOL


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