How is "currently" defined if we intend to give steroids for bronchoconstriction?

This is where a good history gathering comes into play on top of a physical assessment and knowing the pharmacology of the common medications.

In order to define if a patient is “currently on PO or parenteral steroids”, we need to understand what their prescription is. For example, if a patient is prescribed prednisone 50 mg once a day, they are taking it as prescribed, and they are still within that 24-hour period, then they are currently taking a steroid.

If it is outside that prescribed timeframe, they are not currently taking a steroid, and we can administer a subsequent dose (provided they meet the other indications and conditions).

Steroids are not indicated in patients with bronchoconstriction if they’re already on steroids as there is little value added to the patient given the half-life of these medications. In this population, there is a minimal benefit in the risk vs. benefit approach.

If you’re unclear and want to further discuss treatment(s), you can of course always consult with a base hospital physician to determine risks/benefits.