Systemic corticosteroids
A 5-day course of systemic corticosteroids is recommended for exacerbations that don’t respond sufficiently to inhaled bronchodilators. Systemic corticosteroids shorten the duration of hospital admission and hasten return to previous lung function and symptom control. Patients with a written COPD action plan may have already started oral corticosteroids when they present for medical attention.
If the patient can take oral medication, use:
prednisolone (or prednisone) 30 to 50 mg orally, once daily for 5 days. chronic obstructive pulmonary disease, exacerbation prednis ol one
If oral medication cannot be tolerated, use:
hydrocortisone 50 mg intravenously, 6-hourly until oral intake is tolerated. chronic obstructive pulmonary disease, exacerbation hydrocortisone
Switch the patient to oral therapy as soon as tolerated, and continue for a total of 5 days of therapy (oral plus intravenous).
Short courses of prednisolone (or prednisone) can be stopped abruptly without tapering.