Copd Exacerbation Case Study

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Oral vs. IV steroids for COPD exacerbation, is either regimen better?

Chronic Obstructive pulmonary disorder is progressive lung disease characterized by shortness of breath, wheezing, or chronic cough. The disease worsens over time producing more mucus, chest tightness, and additional symptoms. The causes of COPD are cigarette smoking, long-term exposure to chemical fumes and other irritants. The airways can become thick and inflamed.

The standard of care for COPD exacerbations are systemic corticosteroids. Corticosteroids work by binding the glucocorticoid receptor resulting in an increased expression of anti-inflammatory compounds, which then reduce inflammation. This anti-inflammatory effect would then be beneficial in reducing symptoms of COPD exacerbation by decreasing the inflammation of airways. Systemic
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Corticosteroids can be given orally or intravenously and clinicians debate, which route is the most beneficial.

Oral or Iv Prednisolone in the treatment of COPD exacerbations published in the CHEST journal explored possible differences or similarities in oral vs IV therapy with systemic corticosteroids. The paper hypothesized that oral therapy is equivalent to IV therapy. The bioavailability of the oral route is 100%, which would be equivalent to administering the steroid intravenously. Some benefits of the oral route include: ease of administration, the need for fewer personnel and eliminating the need for IV access. The primary outcomes of this study included treatment failure, death, ICU admission, and