Oral steroids for chronic cough

Narrative: Chronic obstructive pulmonary disease (COPD), a term that encompasses both patients diagnosed with chronic bronchitis and emphysema, is an obstructive lung disease in many cases caused by years of tobacco smoking. It is thought that patients with COPD ‘exacerbation’ (increased shortness of breath or change in their chronic cough and sputum) may benefit from steroids, presumably by reducing the inflammatory response that accompanies the exacerbation.

Benefits: 10 studies contributed data for this Cochrane analysis, representing 1051 patients. There was no statistically significant difference in the mortality of subjects who received systemic steroids compared to placebo. In regards to treatment failure, the review found a NNT of 10 (% reduction). Interestingly, no benefit was found in analysis of studies with steroids for less than 72 hours. The reductions in treatment failure were recorded from studies including both admitted and outpatient/Emergency Department patients.

Harms: Corticosteroids can cause multiple side effects, and some studies evaluated harms, though this was inconsistent across studies. When harms were pooled, there was an absolute risk increase of % for patients receiving steroids (NNH = 7) though this includes some harms that are not patient-oriented (high blood sugars) as well as some that are patient-oriented (diarrhea).

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

The doctor may suggest hospitalization simply because it may be necessary to break the cycle of chronic inflammation, or other problems that are exacerbating the illness. Frequently, five or six days of vigorous in-hospital treatment care can result in a dramatic clearing of the eczema. Food tests, allergy skin testing, and the development of an outpatient therapy plan can all be done during the hospitalization. Unfortunately, getting approval from insurers is often difficult. During an acute flare the number of 15-20 minute baths must be increased to three or four per day. Besides hydrating the skin, baths also increase the penetration of topical medication up to ten-fold if the medicine is applied immediately after the bath. Wet wraps after baths may also help hydration and medicinal penetration. Bedtime wet wraps are most practical, and can be done with elasticized gauze followed by ace bandages or double pajamas. (The first pair of pajamas is worn damp but not soaking wet, and a second pair of dry pajamas is worn over them. For a tighter fit, sometimes a plastic sauna suit is used instead of the dry pajamas.) For feet and hands, socks can be used. Additional blankets or increased room heat may be necessary during this three to seven days to prevent chilling.

Checking for bulging or herniated discs using MRI scans or x-rays is also important so as to not delay surgical treatment unnecessarily if cervical spinal nerves are being significantly compressed. Oral steroids may be appropriate in cases where over-the-counter medications, such as NSAIDs , no longer relieve pain, although a reliance on these drugs themselves can also have serious side-effects. Diabetics, and pre-diabetics, should exercise caution with oral steroids as they can significantly affect blood sugar levels. Discussing the options for pain and inflammation management with an experienced physician will help decide the appropriateness of oral steroids as a component of neck pain treatment modalities.

Oral steroids for chronic cough

oral steroids for chronic cough

Checking for bulging or herniated discs using MRI scans or x-rays is also important so as to not delay surgical treatment unnecessarily if cervical spinal nerves are being significantly compressed. Oral steroids may be appropriate in cases where over-the-counter medications, such as NSAIDs , no longer relieve pain, although a reliance on these drugs themselves can also have serious side-effects. Diabetics, and pre-diabetics, should exercise caution with oral steroids as they can significantly affect blood sugar levels. Discussing the options for pain and inflammation management with an experienced physician will help decide the appropriateness of oral steroids as a component of neck pain treatment modalities.

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