Which medications in the drug class Corticosteroids are used in the treatment of Chronic Obstructive Pulmonary Disease (COPD) and Emphysema in Emergency Medicine?

Updated: Aug 15, 2019
  • Author: Paul Kleinschmidt, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Corticosteroids

These agents have been shown to be effective in accelerating recovery from acute COPD exacerbations. Although they may not make a clinical difference in the ED, they have some effect by 6-8 hous into therapy; therefore, early dosing is critical.

Some newer studies are suggesting that inhaled corticosteroids (eg, nebulized budesonide) may be equally effective as intravenous or oral steroids in the mild-to-moderate exacerbation. In addition, level B evidence suggests that the addition of inhaled corticosteroids to oral agents at discharge may be very beneficial.

Methylprednisolone (Solu-Medrol, Medrol)

Methylprednisolone is usually given in intravenous form in the ED for initiation of corticosteroid therapy, although the oral form theoretically is equally efficacious. The two forms are equal in potency, time of onset, and adverse effects. Inhaled corticosteroids are probably equally efficacious and have fewer adverse effects for patients discharged from ED.


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