Endocrine : Corticosteroids
Give the clinical
significance
of termination
of corticosteroid
therapy/ glucocorticoid
withdrawal .
Explain why : icosteroids are not
abruptly stopped/ with drawn but ed
tape
.
gradually
Any patient who has received <
5mg prednisolone equivalents
or :
<20-25 my
for (i should be
hydrocortisone > 14 days . .
e 2-3 c)
, put or a
of gradual
tapered
scheme steroid withdrawal
, i. e
. dose must be down
> °
-
instead
of stopping abruptly
it
20mg hydrocortisone/day
reduction week
every
& then smaller fractions
Steroid of
therapy hypothalmo-pitutary adrenal (MPA) axis
suppression
-> -
dose &
diration
depending
on
↓
adrenal cortex
HPA
suppression
>
- des ACTH level
atrophies
>
-
↓
lock
of endogenous
steroids
↓
if
exogenous
steroids
stopped abruptly
↓
precipitates
- fever+
adrenal
4
insufficiency withdrawal
syndrome
:
electrolyte imbalance
·
malaise ·
w
vpostural
anorexia
·
nausea + ·
weakness
~
hypotension in muscles & joints
pain
· ·
~
,- - -
&
-
- - -
v
,-
Fl
,
Give the clinical
significance
of termination
of corticosteroid
therapy/ glucocorticoid
withdrawal .
Explain why : icosteroids are not
abruptly stopped/ with drawn but ed
tape
.
gradually
Any patient who has received <
5mg prednisolone equivalents
or :
<20-25 my
for (i should be
hydrocortisone > 14 days . .
e 2-3 c)
, put or a
of gradual
tapered
scheme steroid withdrawal
, i. e
. dose must be down
> °
-
instead
of stopping abruptly
it
20mg hydrocortisone/day
reduction week
every
& then smaller fractions
Steroid of
therapy hypothalmo-pitutary adrenal (MPA) axis
suppression
-> -
dose &
diration
depending
on
↓
adrenal cortex
HPA
suppression
>
- des ACTH level
atrophies
>
-
↓
lock
of endogenous
steroids
↓
if
exogenous
steroids
stopped abruptly
↓
precipitates
- fever+
adrenal
4
insufficiency withdrawal
syndrome
:
electrolyte imbalance
·
malaise ·
w
vpostural
anorexia
·
nausea + ·
weakness
~
hypotension in muscles & joints
pain
· ·
~
,- - -
&
-
- - -
v
,-
Fl
,
