03-08-2008, 03:36 PM
Correct Answer = C
The use of corticosteroids to treat acute exacerbations of chronic obstructive pulmonary disease (COPD) was controversial until recently. Although most previous studies showed a favorable effect from treatment with corticosteroids and most practitioners used the drug in this circumstance, previous data were not totally convincing. In a Veterans Administration study of 271 patients with this condition, patients were randomized into three groups: placebo, short-course intravenous corticosteroids with tapering of oral prednisone over 2 weeks, and short-course intravenous corticosteroids with tapering of oral prednisone over 8 weeks. Both groups receiving corticosteroids had shorter hospital stays and experienced less treatment failures than those in the placebo group. Patients receiving the longer course of corticosteroids had no better results than patients receiving the shorter course. Two small studies of patients in emergency department circumstances conflicted about the use of a single dose of intravenous corticosteroids. Single-dose therapy is not favored by most clinicians and has not been tested in studies involving a large number of patients with close follow-up. The role of inhaled corticosteroids in the treatment of stable COPD is controversial at present. However, there are few, if any, advocates for using inhaled corticosteroids in the acute situation
The use of corticosteroids to treat acute exacerbations of chronic obstructive pulmonary disease (COPD) was controversial until recently. Although most previous studies showed a favorable effect from treatment with corticosteroids and most practitioners used the drug in this circumstance, previous data were not totally convincing. In a Veterans Administration study of 271 patients with this condition, patients were randomized into three groups: placebo, short-course intravenous corticosteroids with tapering of oral prednisone over 2 weeks, and short-course intravenous corticosteroids with tapering of oral prednisone over 8 weeks. Both groups receiving corticosteroids had shorter hospital stays and experienced less treatment failures than those in the placebo group. Patients receiving the longer course of corticosteroids had no better results than patients receiving the shorter course. Two small studies of patients in emergency department circumstances conflicted about the use of a single dose of intravenous corticosteroids. Single-dose therapy is not favored by most clinicians and has not been tested in studies involving a large number of patients with close follow-up. The role of inhaled corticosteroids in the treatment of stable COPD is controversial at present. However, there are few, if any, advocates for using inhaled corticosteroids in the acute situation