You see a 47 year-old man with a longstanding history of moderate persistent asthma, usually well controlled with the use of a medium-dose inhaled corticosteroid and infrequent use of a short-acting beta1-agonist. He recently visited a walk-in medical center for the treatment of an acute asthma exacerbation that occurred with a respiratory tract infection. He is currently taking prednisone 40 mg total daily dose prescribed as part of his emergency visit. He has taken this medication for 6 days and has 1 day of medication remaining. Today his PEFR is 90% of personal best and he reports “My breathing is back to normal.” The NP considers that: Question 95 options: A superior therapeutic outcome would likely have been achieved if a long-acting injectable corticosteroid had been used. A one-week tapering dose of prednisone should now be prescribed. The use of short-term systemic corticosteroids is associated with a marked increases in the rate of duodenal ulcer. There is no evidence that tapering a systemic corticosteroid dose following control of pulmonary symptoms and improvement in respiratory function prevents relapse in an asthma flare.

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