Steroid dose for acute bronchitis

Dosing should be individualized based on disease and patient response :

Initial dose: 5 to 60 mg orally per day
Maintenance dose: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response

Comments :
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 to 8 AM) when dosing.
-The delayed-release tablets act similarly to the immediate-release tablets except for the timing of drug release; active drug is released from the delayed-release tablets approximately 4 to 6 hours after intake.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

Uses: As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy as appropriate, such as for the treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.

I have a rare auto-immune disease that requires high (160mg 2x day) dose prednisone to stop a severe blistering of mucosal tissue ., 2-3 degree burns of mouth, throat, sinus, eyes and even my heart. The possibility of this disease killing me without prednisone is real and my doctor explained that prior to prednisone a great majority of people with Erythema Multiforme – Major died.
So what’s the problem? Over many years and a dozen high dose treatments with prednisone I have been 302 committed and upon release my doctors where cautioned about this therapy.
During my most recent treatment, I went into a manic state or worse. I was PFA’d and removed from my home by police after scaring my wife and kids. I had to finish treatments at the hospital and I requested a psychological evaluation because I hadn’t slept in 5 days, almost lost my job, and was was manic or worse. After a discussion with a psychiatrist he added several different mood stabilizers and anti psychotic meds. I have come off the prednisone and the pshyc meds are taking effect. I cant wait until prednisone is out of my system.
My doctor now realizes after this last event a new protocol is being thought out with future treatments.
This I can tell you without a doubt in my mind that Prednisone is a miracle and a curse all rolled up into one medicine. If you are experiencing mental issues with prednisone tell your doctor immediately, insist on getting psychiatric support and PRAY.

Caveats: The trials included here are, in aggregate, relatively small, and compared different corticosteroids, given at different doses, using different routes of administration. Most of the trials used a single dose of dexamethasone, and in the trials that compared routes, there was no significant difference in symptoms between oral and intramuscular injection. In addition, seven of eight trials allowed but did not control for other analgesics. Antibiotics were co-administered with and without steroids, and no studies assessed the efficacy of steroids in the absence of antibiotics. As the majority of pharyngitis cases are viral in etiology and do not benefit significantly from antibiotics 5 , studies assessing the efficacy of steroids in the absence of antibiotics would be useful.

Finally, steroids in general are well tolerated, particularly with short term use, but there are known adverse effects such as hyperglycemia and mood changes. 6 While no harms were identified in this analysis, and although they may be rare, the trials included here were underpowered to detect adverse events.

Only two of the included studies focused on pediatric patients, and together yielded mixed results. In addition, there are reported cases in which steroids have masked acute leukemia in pediatric patients presenting with sore throat. 7 Thus, further study in children is warranted.

Patients with acute spinal cord injuries are a desperate group for whom any neurological recovery can have a major impact on their subsequent functional independence. A return of antigravity strength to even a single muscle at or immediately below a zone of injury is particularly significant to a tetraplegic patient, while a return of a flicker of movement to several muscles below a zone of injury is of little functional value unless antigravity strength can be attained. 20  There may be some utility for methylprednisolone in tetraplegics and in incomplete conus injuries, but only if the results from the post hoc analyses of the NASCIS II study and Otani and colleagues' study can be substantiated in future randomized, blinded trials.

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

Steroid dose for acute bronchitis

steroid dose for acute bronchitis

Patients with acute spinal cord injuries are a desperate group for whom any neurological recovery can have a major impact on their subsequent functional independence. A return of antigravity strength to even a single muscle at or immediately below a zone of injury is particularly significant to a tetraplegic patient, while a return of a flicker of movement to several muscles below a zone of injury is of little functional value unless antigravity strength can be attained. 20  There may be some utility for methylprednisolone in tetraplegics and in incomplete conus injuries, but only if the results from the post hoc analyses of the NASCIS II study and Otani and colleagues' study can be substantiated in future randomized, blinded trials.

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