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I'm going to pump you up!
When it comes to asthma, steroids are a life-saver.
Early intervention of steroids in acute asthma exacerbation not only reduces hospital admission rates but reduces relapse rates as well.
Does it matter what type of steroid I give?
Hmmm....
Let's break that question down. It has been the standard to give prednisone 2mg/kg, max 60mg x 5 days for outpatient treatment of asthma exacerbation, and it works. However, new studies are substituting prednisone with dexamethasone (Decadron) 0.6mg/kg, max16mg x 2. Here's the breakdown:
I. dexamethasone has a longer half-life, thus will require fewer doses
II. dexamethasone may have less vomiting?
III. dexamethasone tastes better than prednisone, which could help increase compliance (especially kids)
So far the studies have shown dexamethasone to be just as effective!
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Check out that mucus plug!!!!→
Now there's even research suggesting a SINGLE IM dose of dexamethasone is just as effective (in children)! Will it be validated?! Stay tuned....
References:
Kravitz, J., Dominici, P., Ufberg, J., Fisher, J., & Giraldo, P. (August 2011). Two Days of Dexamethasone versus 5 day of Prednisone in the Treatment of Acute Asthma: A Randomized Controlled Trial. Ann Emerg Med, 58(2):200-4. doi: 10.1016/j.annemergmed.2011.01.004.
Qureshi, F., Zaritsky, A., & Poirer, M.P. (Jul 2001) Comparative Efficacy of Oral Dexamethasone versus Oral Prednisone in Acute Pediatric Asthma. J Pediatr, 139(1): 20-6.
Shefrin, A.E., Goldman, R.D. (July 2009). Use of Dexamethasone and Prednisone in Acute Asthma Exacerbations in Pediatric Patients. Can Fam Phys 55(7):704-706
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