Tapering schedule for Glucocorticoids There are many methods to taper GCs after the disease manifestations are brought under control. In some diseases, GCs can be tapered rapidly. In other chronic inflammatory diseases such as systemic lupus erythematosus (SLE), inflammatory myositis, and systemic vasculitis, the taper must be slower. The following is one possible taper schedule: …
basic measures that should be performed routinely for patients receiving GCs to reduce the chance of an adverse reaction • Prescribe corticosteroids at the lowest possible dose and taper the dose as soon as the disease activity permits. • Encourage physical activities and avoid immobilization (helps prevent myopathy). • Implement fall prevention program. • Prescribe dietary and supplemental calcium …
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How common is adrenal atrophy in patients taking Glucocorticoids? Exogenous administration of GCs is the most common cause of adrenal insufficiency, resulting from suppression of adrenocorticotropic hormone (ACTH). Any patient who is Cushingoid in appearance, has received >20 mg of daily prednisone for >3 weeks, has been on ≥5 mg/day for >1 year, or has …
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Which group of corticosteroid medications results in the least amount of sodium retention? Sodium retention is dependent upon the mineralocorticoid effect of the preparation. It is insignificant in the usual doses of methylprednisolone, triamcinolone, paramethasone, betamethasone, and dexamethasone Mineralocorticoid Properties of Glucocorticoid Preparations Glucocorticoid Mineralocorticoid Potency a Short-acting Hydrocortisone (cortisol) 1 Cortisone 0.8 Intermediate-acting Prednisone 0.25 …
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What are some of the adverse consequences of Glucocorticoids therapy? At what dose (prednisone) does risk increase the most? • Glucose intolerance and increased triglycerides attributable to insulin resistance (doses >10 mg/day). • Growth suppression in children (less if dose kept ≤0.5 mg/kg). • Osteonecrosis (risk at dose >20 mg/day for 1 month). • Ophthalmologic: posterior subcapsular cataract formation …
What factors may affect Glucocorticoids dose efficacy? • Age. Children aged <12 years clear GCs 33% faster. • Diseases. Severe liver disease: may not convert prednisone to prednisolone (active form). Failure to normalize the INR with vitamin K indicates severe liver disease. Hyperthyroidism, nephrotic syndrome, and hemodialysis increases GC clearance. • Medications. Aluminum/magnesium antacids reduce absorption by 40%. …
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How do the Glucocorticoids properties of corticosteroids compare with cortisol? The GC potency of medications correlates in part with the duration of biologic activity Glucocorticoid Properties of Corticosteroid Preparations Glucocorticoid Glucocorticoid Potency a Short-acting Hydrocortisone (cortisol) 1 Cortisone 0.8 Intermediate-acting Prednisone 4 Prednisolone 4 Methylprednisolone 5 Triamcinolone 5 Long-acting Paramethasone 10 Betamethasone 25 Dexamethasone 30 to …
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