From the Guidelines
It is recommended to continue taking prescribed steroids before a pulmonary function test (PFT) as they are part of your baseline respiratory function. When considering pulmonary function testing, the goal is to assess lung function in the context of the patient's regular treatment regimen 1.
Key Considerations
- The choice of whether to continue or withhold medication prior to testing depends on the clinician's objectives for the test 1.
- If the aim is to determine potential improvement with additional therapy, patients should continue their regular medication, including steroids 1.
- However, for assessing reversibility of airflow limitation, certain medications like short-acting inhaled drugs should be withheld for a specified period before testing 1.
Medication Guidance
- Inhaled corticosteroids and oral steroids should be taken as normally scheduled before the test.
- Rescue inhalers like albuterol should be avoided for 4-6 hours before the test unless necessary.
- It's crucial to inform the test technician about all medications taken that day, including steroids.
- For personalized guidance on specific medications, patients should consult their healthcare provider before the test.
From the Research
Effects of Steroids on Pulmonary Function Tests
- The use of corticosteroids, both oral and inhaled, can have significant effects on lung function in patients with asthma and chronic obstructive pulmonary disease (COPD) 2.
- Inhaled corticosteroids may improve lung function when added to a beta-agonist for treatment of acute asthma, while oral corticosteroids have established efficacy in this setting 2.
- However, the effect of corticosteroids on pulmonary function tests (PFTs) is not directly addressed in the provided studies.
Pre-Test Considerations for Pulmonary Function Tests
- Coaching patients during PFTs is crucial to ensure optimal performance and acceptable test quality 3.
- Factors that may hinder patient performance, common mistakes during testing, and tips for registered respiratory therapists to help patients optimize their performance are discussed in the literature 3.
- There is no specific guidance on the use of steroids prior to PFTs.
Interpretation of Pulmonary Function Tests
- PFTs include spirometry, static lung volumes, lung diffusion, arterial blood gas, methacholine challenge test, and 6-minute walk test 4, 5.
- Interpretative strategies for lung function tests recommend defining abnormal tests using the 5th and 95th percentiles of predicted values 4.
- The provided studies do not address the specific question of taking steroids prior to PFTs.
Use of Inhaled Corticosteroids in COPD
- The clinical evidence for using inhaled corticosteroids in COPD is limited by methodological problems, and there is no clear benefit on reducing severe exacerbations or improving FEV1 decline 6.
- The use of inhaled corticosteroids in COPD may be associated with substantial adverse effects, including severe pneumonia 6.
- The presence of eosinophilic inflammation in the sputum is a predictor of response to inhaled corticosteroids in COPD 6.