The use of systemic steroids in the treatment of acute COPD exacerbations is widely accepted and recommended, given their high efficacy. A systematic review concluded that even patients with mild COPD exacerbations can benefit from systemic corticosteroids.
Conversely, the use of oral steroids in persons with chronic stable COPD is widely discouraged, given adverse effects that include hypertension, glucose intolerance, osteoporosis, fractures, and cataracts. Inhaled corticosteroids provide a more direct route of administration to the airways, and similar to other inhaled agents, they are only minimally absorbed. Consequently, aside from the development of thrush, the systemic adverse effects of these medications at standard doses are negligible. The current Institute for Clinical Systems Improvement (ICSI) guidelines conclude that inhaled steroids are appropriate in patients with recurrent exacerbations of COPD.
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Cite this: Fast Five Quiz: Can You Properly Identify and Treat COPD? - Medscape - Feb 04, 2022.