Episode 104: A high dose of acute asthma therapeutics

In episode 104, Mike and James blow out a lot of hot air about the use of medications for acute asthma and they come to the quick realization that the concepts they have been evangelising for the past 2 years (low dose and shared-informed decision making) have no role in acute asthma.

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Comments

Hi, I had just wondered what

Hi, I had just wondered what your comments are about tapering oral steroid doses, i think you said half way through the podcast that you'd talk about it but then I think either I missed it or you moved on ... Do you have any advice about how many days a patient would have to be on a therapeutic level of prednisolone (40-50mg) before it would be necessary to taper the dose of, my practice has been that if its a one-off course e.g. 5-7 days, then one can stop abruptly, whereas if , as is frequently the case, one needs to repeat this imediately i.e. perhaps 10-14 days of oral pred 40-50mg, then one should think about tapering this off, although how fast seems to be personal decision ; whether this is evidence based I dont realy know - I think that I maybe read somewhere sometime about adrenal suppression becoming relevant after about 10 days ( I may be making that up !!) Any advice chaps ?? Raymond