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Tuesday, June 18, 2013
COPD (Chronic Obstructive Pulmonary Disease)
Long Term Prednisone Usage
My 77 y/o aunt is a difficult end stage COPD patient. She refuses chest xray or lung function studies and still smokes. She is on oxygen 24hours. Taking prednisone during exacerbations at 40mg/bid and tapering 5mg/day. It seems in the last 2 months that once she reaches the 5/10 mg level, she crashes again. If she can complete that taper, she can only stay there a few days. Is a continuous "maintenance" dose possible? Has she developed a physical dependence on the prednisone?
Thank you for visiting NetWellness. There are situations when patients need to be maintained on chronic prednisone for COPD. In general, we try to use the lowest dose of prednisone that keeps symptoms controlled. The lungs do not build dependence to prednisone. When people have severe disease with ongoing inflammation from continued tobacco exposure medications do not work as well.
Michael E Ezzie, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University