In the true spirit of Emergency Medicine our content is available to anyone, anywhere, anytime.Have feedback? Oral and parenteral dexamethasone have similar bioavailability, with a duration of action of 72 hours. A single dose of oral dexamethasone 12mg may be a reasonable alternative to a 5-day course of prednisone 60mg for adults with asthma exacerbations. Expert Panel Report 3. Patients in both groups were ventilated with lung-protective mechanical ventilation. However, due to the strong association with low patient adherence and poor outcomes, a single dose of a long acting oral medication in the ED may help prevent relapse of symptoms. Children under 12 years: There is no experience of the use of COMBIVENT UDVs in children under 12 years. In 2004, Lahn et al evaluated the use of a single dose of IM methylprednisolone compared to an 8-day taper of oral methylprednisolone among 180 adults Patients in the dexamethasone group received an intravenous dose of 20 mg once daily from day 1 to day 5, which was reduced to 10 mg once daily from day 6 to day 10. However, due to issues of patient compliance with treatment regimens, a single dose of 12mg of dexamethasone by mouth seems like a reasonable alternative to a 5-day course of prednisone for adults with acute asthma exacerbations. Single Dose Dexamethasone in Adult Asthma Exacerbations A randomized controlled noninferiority trial of single dose of oral dexamethasone versus 5 days of oral prednisone in acute adult asthma Ann Emerg Med, 2016. Bethesda, MD: National Institutes of Health; 2007:1-404"Single Dose Dexamethasone or 5 Days of Prednisone in Adult Asthmatics? Administration: Please refer to the patient information leaflet for instructions for use with a nebuliser. Bethesda, MD: National Institutes of Health; 2007:1-404 Given that up to 28% of patients do not fill prescriptions written from the ED (Saunders 1987, Thomas 1996), and given the acceptance of single-dose dexamethasone for asthma exacerbation in children, further evaluation of Prednisone is shorter acting, with a half-life of 18 to 36 hours. In the US, 8.4% of the population is affected by the … There has been promising data on dexamethasone for acute asthma from the pediatric literature, as well as a 2-dose regimen in adults. Relapse, or a return visit for asthma within 14 days:Single dose oral dexamethasone isn’t non-inferior (Not Non-inferior = Sacrifice small amount of benefit for simpler dosing schedule) Patients, physicians and research assistants who assessed outcomes were all blinded to the interventionBaseline characteristics between groups were evenly matched The primary outcome is patient centered and clinically importantExtensive exclusion criteria limits the applicability of these results to the general ED asthma population20% of the study population was lost to follow up, which may have influenced resultsUsing telephone follow up survey to assess primary and secondary outcomes is influenced by recall bias of the subjects, and limits the reassessment of the subject’s current condition without a physical examinationA single center study limits generalizability to other settingsOral prednisone has a bitter taste and patients may have been unintentionally unblinded to treatment arm as a resultThe frequency of relapse was slightly higher with dexamethasone than prednisone (12.1% versus 9.8%),with an absolute difference was only 2.3%. The frequency of relapse was slightly higher with dexamethasone than prednisone (12.1% versus 9.8%),with an absolute difference was only 2.3%. In the true spirit of Emergency Medicine our content is available to anyone, anywhere, anytime.Have feedback?

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