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I work in a general community ER, so I will likely never even have a big enough subjective ’n’ to make a comment, but last year I had a parent of an asthmatic ask me for dex instead of pred as it didn’t make their son so ‘crazy’.  That was enough for me to start making the switch.  I would like to see some harder data though.  A great study idea!

Terence Bergmann
Concordia Hosp ER
Winnipeg, MB


> On Jan 25, 2015, at 4:23 PM, Amy Johnson <[log in to unmask]> wrote:
> 
> Hello to all,
> 
> I was wondering if anybody has any experience/opinions or knowledge of any articles that discuss the side effect profile, specifically behavioral side effects of dexamethasone vs prednisolone for treatment of asthma exacerbations. There are several studies including recent meta analysis in Pediatrics Feb 2014 supporting 1-2 doses of dexamethasone vs 4-5 day course of prednisone or prednisolone for treatment of asthma exacerbations. They do mention less vomiting with dexamethasone, but no mention of behavioral side effects.
> 
> I have done my own very informal non controlled mini study of 3 patients in which the parents stated that the child had a history of serious behavioral side effects with prednisolone (anger problems, aggression, poor sleep). I treated these children with a single dose of dexamethasone and followed up with the family by phone 1-2 weeks later. All parents said that the child had no behavioral side effects. All patients were in 3-5 year old age group. Wondering if anybody else has noticed this difference with the behavioral side effects? Maybe a good study idea?
> 
> Thanks,
> 
> Amy E. Johnson, M.D.
> Carepoint, PC
> Rocky Mountain Hospital for Children
> Denver, Colorado
> 
> 
> 
> 
> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
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> 
> 

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html