Do any asthmatics take something like oral prednisolone as opposed to inhaled corticosteroids? Is it a recognized standard of treatment if the latter fails or even just a valid alternative per se?
it's an emergency treatment when you're so unable to breath even a nebulizer won't help. it is not a valid alternative to inhaled steroids because it fucks with your entire endocrine system and can lead to long term heart, lung, kidney, and nervous disorders
Long term side effects of oral pred can get pretty nasty
Yeeeah, I have an autoimmune disease (in the rheumatoid arthritis family, currently diagnosed as psoriasis) where steroids are the first-line treatment, and medical professionals don’t even recommend using topical steroids every day (which have localized effects like an inhaler), let alone oral steroids affecting your entire system.
I get the frustration, I freaking hate applying topical meds and would gladly take a pill once or twice a day instead, but the side effects would be way worse than my current symptoms if I did : (
I'm not familiar with treating asthma in humans, but I have a severely asthmatic cat. The prednisolone is not the preferred treatment, it is used to manage flareups that can't be controlled with inhaled steroids. The inhaler is preferred because the steroids are localized to the lungs only and have fewer side effects compared to the prednisolone which affects the entire body and is more problematic long term.
TLDR: If you were my cat you'd be getting an inhaler and prednisolone only when necessary
What is the dosing and schedule for administering the meds? Also how what makes you think this about cats?
I assume it's about humans, but the treatment methods are the same according to my Vet and The pharmacist. The only difference is cats cannot metabolize prednisone and need prednisolone instead. Whereas humans can use both
It's the same Flovent that humans would get, he was started on 50mcg dose once per day, And now takes 125mcg dose twice per day. Prednisolone is 5mg once per 1-2 days as needed "Give lowest most effective dose"
Those levels would be larger for a person, ymmv
I would imagine it’s an emergency basis.
Typical line of treatment goes:
Buuut that’s experience in the US with asthma. Other places in the world may differ.
That’s the old guidelines. Current guidelines are combo maintenance inhaler as needed to start, then move to every day if needed. Singulair and nebulizers for asthma are falling out of favor as well.
Which is a shame, since I know I personally can’t do maintenance inhalers safely with a weak immune system as it is. I can’t be the only one, surely.
I get the reasoning for Singulair due to its black box warning, though.
Inhaled meds work almost instantly, 99% of oral meds take up to an hour to even hit the bloodstream, often more to hit peak blood concentration. If inhaled meds aren't working you don't have time for an oral med to work; at that point you're tubing the person.
A corticosteroid also has way too many side effects to be taken long term, like another user said. Long term you're talking one of the more targeted immune modifying drugs like singulair.
Now what you would still use a corticosteroid for is an acute exacerbation that's not an emergency. So like, pneumonia where you've got the person on a shitton of antibiotics and you need their inflammation to sit down and shut up for a second while they work. So their throat hasn't actually started closing up yet but it might try if you don't use the steroid.
Hope this helps.
(I do see some people saying best practice is shifting away from this; I work psychiatry so our patients aren't always getting top of the line care. I take whatever bones the hospitalist deigns to throw us, LOL)