“Does treatment of COPD require steroids?”
My mother has COPD and is currently in oxygen therapy because it's still mild. But once her condition worsens, would she have to start taking steroids?
9 Answers
It all depends on the severity of the COPD and whether it is acute aggravation. Sometimes steroids are given in the inhaler for the maintenance therapy also in COPD
Yes, standard treatment of COPD is inhailed steroids and oral steroid when there are exacerbations or end stage.
Discuss with your doctor. Treatments are case to case
Sometimes steroids will be used but this will be up to her pulmonologist. They may have her do a PFT test to get an idea of lung function.
Long-term management of COPD is different from treatment of acute COPD exacerbations. For moderate or severe acute exacerbations, oral or IV steroids have proven to improve pt outcomes, symptoms, and shorten hospital stay. For long-term management of more severe COPD classes (e.g. GOLD class D) inhaled steroids are recommended. In general, oral or IV steroids are not recommended for long-term management of COPD.
Not necessarily. Some patients with COPD have some inflammation, others do not. The patients who have inflammation are the ones who get better with steroids. The steroids are usually given via an inhaler.
Usually, we use systemic steroids (by mouth or IV) for the flare-ups. Long-term steroid is very deleterious to the health and we try to avoid it. Maybe steroid inhalers would be indicated.
Steroids may be needed for an exacerbation, especially if oxygen, bronchodilators, and maybe anticholinergics and/or antibiotics do not work. USUALLY, once the exacerbation has resolved, the steroids are stopped (or weaned off) as long as the patient tolerates it without deteriorating.
Sometimes COPD that is severe (like in a patient on chronic oxygen) MAY require daily steroid therapy (at the lowest does that works). But this is only when standard medications like bronchodilators and anticholinergics don't work well enough; then a steroid trial may be helpful. Then, the patient's clinical course will dictate whether daily steroids are needed chronically.
Sometimes COPD that is severe (like in a patient on chronic oxygen) MAY require daily steroid therapy (at the lowest does that works). But this is only when standard medications like bronchodilators and anticholinergics don't work well enough; then a steroid trial may be helpful. Then, the patient's clinical course will dictate whether daily steroids are needed chronically.
Steroids are a blanket anti inflammatory therapy and has to be used appropriately in the right circumstance.
