Q. I have patients previously diagnosed as Asthma who are now classified as COPD. Should I keep them on inhaled steroids?

A. If you have a strong suspicion that your patient has COPD rather than asthma (smoking history, progressive shortness of
breath), then you should slowly reduce the dose of inhaled steroids (over several months - e.g. 25% reduction every 2-3 months). In most patients with COPD you will be able to withdraw the inhaled steroid completely, without any increase in symptoms or change in lung function.



Q. What is a recommended 'steroid trial' for COPD?

A. The most frequently used regime for a steroid trial is to give oral prednisolone (40mg daily in a single morning dose) for 2 weeks. It is best to make measurements of peak expiratory flow (PEF) twice a day for 2 weeks before starting oral steroids in order to get a baseline value and then during the treatment period. FEV, should be measured at the beginning and end of the baseline period and after the......

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Title: Steroids
Approximate Word Count: 469
Approximate Pages: 2 (250 words per double-spaced page)

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