A single dose of intramuscularly administered dexamethasone acetate is as effective as oral prednisone to treat asthma exacerbations in young children

Dexamethasone for Acute Asthma Exacerbations in Children: A Meta-analysis

“…Application of inclusion and exclusion criteria resulted in 6 studies that were included in our analysis (Fig 1). [11][12][13][14][15][16] All of the included studies were performed in EDs and had a mean of 171 participants (range 15-272). All studies but one (Gordon et al 12 ) defined relapse as an unplanned clinic visit, return ED visit, or an unplanned hospital admission related to their initial asthma exacerbation.…”

“…All studies but one (Gordon et al 12 ) defined relapse as an unplanned clinic visit, return ED visit, or an unplanned hospital admission related to their initial asthma exacerbation. Dexamethasone was given as a single IM dose in 3 studies, 12,14,15 as a single oral dose in 1 study, 11 and as multiple oral doses in 2 studies 13,16 (Table1). Included studies were from the United States (n = 5) and Canada (n = 1).…”

“…The 4 studies that reported 5-day follow-up relapse rates all used a single dose of IM or PO dexamethasone. 11,12,14,15 Five days was the most common follow-up duration and is the most clinically relevant period in which to detect treatment failure. This is supported by the fact that 5-day courses of oral corticosteroids have not been shown to be superior to 3-day courses for outpatient management of children with acute exacerbations.…”

Mortality in Asthma-Chronic Obstructive Pulmonary Disease Overlap in the United States

“…Intravenous corticosteroids can be administered when patients are too dyspneic to swallow; if the patient is vomiting; or when patients require non-invasive ventilation or intubation. In patients discharged from the emergency department, an intramuscular corticosteroid may be helpful, 372 especially if there are concerns about adherence with oral therapy. Duration: 5-and 7-day courses in adults have been found to be as effective as 10-and 14-day courses respectively, 352,353 and a 3-5-day course in children is usually considered sufficient (Evidence B).…”

Characterization of the Antiallergic Drugs 3-[2-(2-Phenylethyl) benzoimidazole-4-yl]-3-hydroxypropanoic Acid and Ethyl 3-Hydroxy-3-[2-(2-phenylethyl)benzoimidazol-4-yl]propanoate as Full Aryl Hydrocarbon Receptor Agonists

“…However, while this Mosmann paradigm (5) has proven useful and simplifies how immunological diseases are analyzed and classified, its application to other immune cells, namely, CD8 + lymphocytes, is still occasionally challenged by complex signaling and phenotypic manifestations that cannot be fit into the T H 1-T H 2 paradigm (6,7). Regardless, T H 2-driven conditions such as the acute relapse symptoms of atopic asthma and airway hyperresponsiveness are commonly treated with steroid drugs, such as the glucocorticoid receptor agonists dexamethasone and prednisone (8). Unfortunately, these drugs have global immunosuppressive properties toward both T H 1-and T H 2-driven clinical conditions (9,10) and can also become ineffective during their prolonged use (11).…”