Glucocorticoids prednisone

The ACR recommends bisphosphonate therapy for all patients who are starting treatment with glucocorticoids (prednisone greater than or equal to 5 mg daily or equivalent) that will continue for 3 months or longer. For patients receiving chronic... 

Frerichs, V.A., Tomatore, K.M. Determination of the glucocorticoids prednisone, prednisolone, dexamethasone, and cortisol in human serum using liquid chromatography coupled to tandem mass spectrometry. J. Chromatogr. B 802, 329-338 (2004)... 

A. Glucocorticoids Prednisone is the most commonly used glucocorticoid in cancer chemotherapy. The steroid has applications in dmg regimens for acute and chronic lymphocytic leukemia. Hodgkin s disease (MOPP regimen), and other lymphomas. Toxicity is described in Chapter 39. 

The client with inflammatory bowel disease is prescribed the glucocorticoid prednisone. Which priority intervention should the nurse implement ... 

The client is scheduled for a bilateral adrenalectomy for Cushing s disease. Which information regarding the prescribed glucocorticoid prednisone (Deltasone) should the nurse teach Select all that apply. 

Management Glucocorticoids are the first-line treatment in type 2 amiodarone-induced thyrotoxicosis, and thionamides play no role. In a matched retrospective cohort comparison of the ejficacy of a thionamide (methimazole) or a glucocorticoid (prednisone) for 40 days in type 2 amiodarone-induced thyrotoxicosis, in 42 patients, 23% of those who took prednisone were still thyrotoxic, compared with 86% of those who took methimazole [39 ]. When those who had taken methimazole were then given prednisone, 94% achieved euthyroidism within another 40 days. 

Always ask about a family history of diabetes-2. A close family history can predispose to (a) manifestation of diabetes-2 by glucocorticoid/prednisone treatment, and (b) genetico-diabetoid-2 dysimmune polyneuropathy. 

Glucocorticoid doses of less than 7.5 mg/day of prednisone (or its equivalent) for fewer than 3 weeks generally would not be expected to lead to suppression of the hypothalamic-pituitary-adrenal axis. 

Gradually taper the dose to approximately 20 mg of prednisone or equivalent per day, given in the morning, then ° Change glucocorticoid to every other day administration, in the morning. 

Stop the glucocorticoid when the equivalent physiologic dose is reached (20 mg/day of hydrocortisone or 5-7.5 mg/day of prednisone or equivalent). 

Glucocorticoids may increase platelet production by impairing bone marrow macrophage ability to destroy platelets. Response rate to oral prednisone (1-1.5 mg/kg per day) in adults is 50% to 75% and usually occurs within the first 3 weeks. In children, severe life-threatening bleeding is treated with either high-dose oral (4—8 mg/kg per day prednisone) or parenteral (30 mg/kg per day methylprednisolone) glucocorticoids. 

Hydrocortisone, cortisone, and prednisone are the glucocorticoids of choice, administered twice daily at the lowest effective dose while mimicking the normal diurnal rhythm of cortisol production. 

The use of glucocorticoids for tuberculous meningitis remains controversial. The administration of steroids such as oral prednisone, 60 to 80 mg/ day (1 to 2 mg/kg/day in children), or 0.2 mg/kg/day of IV dexametha-sone, tapered over 4 to 8 weeks, improves neurologic sequelae and survival in adults and decrease mortality, long-term neurologic complications, and permanent sequelae in children. 

Glucocorticoids 40-60 mg oral prednisone equivalents thrombocytopenia Serious infections hypersensitivity icity hepatotoxicity Diabetes osteoporosis infection... 

Short-term use of glucocorticoids, even in massive dosages, is less likely to produce harmful reactions. They can, however, produce a variety of effects that are neither limited to high doses nor to long-term therapy. When a low dose of steroids (prednisone) was given for several months to a 38-year-old man to treat eczema of his hands and feet, he developed bilateral avascular necrosis (AVN) of the femur. He therefore had total bilateral hip replacement, and several experts have attributed his AVN to the steroid administration. The man sued his allergist, who settled the lawsuit shortly before trial for approximately 400,000. Most practitioners, however, are unaware of the risk of short-term or low-dose steroids. Yet many of these cases can be found in the courts, the literature, and the MedWatch databases. 

The exogenous administration of glucocorticoids can result in hypothalamic-pituitary-adrenal axis (HPA) suppression, which may subsequently lead to adrenal atrophy The degree of adrenal suppression is dependent on the dosage, duration, frequency, time, and route of administration of the specific glucocorticoids. At least one patient who received prednisone for neurological symptoms developed Cushing s syndrome. ... 

The primary endogenic glucocorticoids are hydrocortisone and cortisone. Numerous synthetic analogs of natural glucocorticoids have been made and used, and they have turned out to be more effective, and currently they have almost completely replaced cortisone (prednisolon, prednisone, dexamethasone, and others). 

Many synthetic glucocorticoid derivatives are widely used as immunodepressants. Glucocorticoids (cortisone, prednisone, methylprednisolone, betamethasone, dexamethasone,... 

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