Glucocorticoids in clinical practice.

摘要: The many unique features of glucocorticoids makes therapy with these steroids challenging. anti-inflammatory potency, relative mineralocorticoid activity, plasma half-life, and route administration the synthetic cortisol preparations are compared. Because they produce profound immunosuppressive effects, exogenously administered effective for a variety diseases conditions. appropriate dosing regimen is an adequate dose sufficient period to precipitate acceptable response. It impossible predict that will suppress hypothalamic-pituitary-adrenocortical (HPA) axis thereby increase risk developing adrenal insufficiency during periods stress. Until recovery complete, patients require daily physiologic replacement doses; high-dose supplemental may be required major illness or surgery. Once there signs improvement, should adjusted single morning dose, then alternate-day regimen, and, as soon possible, steroid discontinued. This tapering process maintains disease suppression while minimizing toxicity; however, it often complicated by exacerbation withdrawal symptoms. Potential complications associated glucocorticoid numerous, involve all organ systems, potentially more devastating than HPA suppression.