Optimum management of glucocorticoid-treated patients.

摘要: Glucocorticoids are taken by approximately 2% of the US adult population at any given time. The powerful anti-inflammatory and immunosuppressive benefits these drugs must, however, be weighed against their multisystem adverse effects. Clinicians should always prescribe lowest possible dose for shortest Patients informed short-term long-term effects to expect, particularly if glucocorticoids is expected exceed equivalent 7.5 mg prednisone daily 2 months or more. At commencement glucocorticoid therapy, a patient's blood pressure, lipid profile, 25-hydroxyvitamin D(3) level fasting glucose measured baseline bone densitometry performed. Bisphosphonate therapy initiated postmenopausal women men with density T-score below -1 those history fracture. Regular ophthalmic screening cataracts glaucoma warranted, patients high-risk gastric ulceration (especially simultaneously taking nonsteroidal drugs) receive proton-pump inhibitors. Prophylaxis opportunistic infections appropriate populations, such as organ-transplant recipients. Trimethoprim plus sulfamethoxazole can organ transplant duration weaning from treatment proportionate duration. Appropriate preventive mitigate many associated therapy.