steroid dosepaks

Q: 37 years old male is admitted to ICU with Gastrointestinal (GI) bleed after he was prescribed 'medrol dosepak" for his COVID-like symptoms. Prepackaged steroid courses are relatively safe?

A) True

B) False

Answer: In the United States, it is a very popular practice to prescribe 'medrol dosepack' when steroid is indicated. Nearly half of the steroids prescribed in the USA are prepackaged. Unfortunately, these prepackaged 'dosepaks' are not only relatively expensive but also deliver a higher glucocorticoid dose in less than a week. 

The other objective of this question is also to clear the misconception that short courses of steroids are safe. These short courses can also cause serious side effects, though association seems linear with dose and period of the course.

#pharmacology

References:

1. Waljee AK, Rogers MA, Lin P, et al. Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study. BMJ 2017; 357:j1415. 

2. Yao TC, Huang YW, Chang SM, et al. Association Between Oral Corticosteroid Bursts and Severe Adverse Events : A Nationwide Population-Based Cohort Study. Ann Intern Med 2020; 173:325.