Corticosteroids dosage for asthma

Elderly: The serious consequences of corticosteroid side effects should be carefully considered when initiating therapy.

Doses should be titrated based on patient response and severity of the condition; patients should be continuously monitored for signs that may require a dosage adjustment :
-Increased doses may be needed during periods of stress (., surgery, infection, trauma) or, exacerbations of condition
-Dose reductions should occur once an adequate response is obtained
-If a beneficial response is not achieved within a couple of days, treatment should be discontinued and an alternative therapy considered.

Gradual discontinuation of therapy is warranted if therapy is to be stopped after more than a few days.

Approximate Equivalents (IV or oral formulations):
Hydrocortisone 20 mg is approximately equivalent to betamethasone mg
Hydrocortisone 20 mg is approximately equivalent to dexamethasone mg
Hydrocortisone 20 mg is approximately equivalent to methylprednisolone 4 mg
Hydrocortisone 20 mg is approximately equivalent to triamcinolone 4 mg
Hydrocortisone 20 mg is approximately equivalent to prednisolone 5 mg
Hydrocortisone 20 mg is approximately equivalent to prednisone 5 mg
Hydrocortisone 20 mg is approximately equivalent to cortisone 25 mg

There is no evidence of safe and effective use of topical corticosteroids in pregnant mothers. Therefore, they should be used only if clearly needed. Long term use and large applications of topical corticosteroids may cause birth defects in the unborn. It is not known whether topical corticosteroids enter breast milk. Therefore, caution must be exercised before using it in nursing mothers. Topical corticosteroids should not be applied to the breasts of nursing mothers unless the mothers instructed to do so by the physician.

Corticosteroids have been used as drug treatment for some time. Lewis Sarett of Merck & Co. was the first to synthesize cortisone, using a complicated 36-step process that started with deoxycholic acid, which was extracted from ox bile . [43] The low efficiency of converting deoxycholic acid into cortisone led to a cost of US $200 per gram. Russell Marker , at Syntex , discovered a much cheaper and more convenient starting material, diosgenin from wild Mexican yams . His conversion of diosgenin into progesterone by a four-step process now known as Marker degradation was an important step in mass production of all steroidal hormones, including cortisone and chemicals used in hormonal contraception . [44] In 1952, . Peterson and . Murray of Upjohn developed a process that used Rhizopus mold to oxidize progesterone into a compound that was readily converted to cortisone. [45] The ability to cheaply synthesize large quantities of cortisone from the diosgenin in yams resulted in a rapid drop in price to US $6 per gram, falling to $ per gram by 1980. Percy Julian's research also aided progress in the field. [46] The exact nature of cortisone's anti-inflammatory action remained a mystery for years after, however, until the leukocyte adhesion cascade and the role of phospholipase A2 in the production of prostaglandins and leukotrienes was fully understood in the early 1980s.

Corticosteroids dosage for asthma

corticosteroids dosage for asthma

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