A patient has been taking oral prednisone 60 mg daily for 3 days for an asthma exacerbation, which has resolved. The patient reports having gastrointestinal (GI) upset. The primary care nurse practitioner (NP) should:
a. discontinue the prednisone.
b. begin tapering the dose of the prednisone.
c. order a proton pump inhibitor (PPI) to counter the effects of the steroid.
d. change the prednisone dosing to every other day.
A
The patient's asthma symptoms have resolved, so the prednisone may be discontinued. If the patient has been on the medication for a few days, it is not necessary to taper the dose before the patient stops taking it. If the patient required long-term dosing of the steroid, a PPI could be used. Every-other-day dosing is used. Alternate-day dosing is sometimes used for long-term therapy to minimize suppression of the hypothalamic-pituitary-adrenal (HPA) axis.
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