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Guía práctica para dejar de tomar glucocorticoides

Faran Khalili1,2, Morton G Burt1,2

  • 1Southern Adelaide Diabetes and Endocrine Services, Flinders Medical Centre, Adelaide.

Australian prescriber
|August 27, 2025
PubMed
Resumen
Este resumen es generado por máquina.

Los glucocorticoides utilizados a corto plazo pueden suspenderse abruptamente. El uso prolongado requiere una disminución gradual para prevenir la insuficiencia suprarrenal, con pruebas de cortisol como guía para el cese en algunos pacientes.

Palabras clave:
Eje HPAInsuficiencia suprarrenaldisminución gradual de las drogasSíndrome de abstinencia de los glucocorticoidesLos glucocorticoides

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Área de la Ciencia:

  • Endocrinología
  • Farmacología

Sus antecedentes:

  • Los glucocorticoides son medicamentos comúnmente recetados.
  • El uso a corto plazo (menos de 3 a 4 semanas) generalmente no requiere disminución gradual de la dosis.
  • El uso prolongado puede conducir a la supresión del eje hipotálamo-hipófisis-adrenal (HPA).

Objetivo del estudio:

  • Para describir el manejo de la interrupción de los glucocorticoides.
  • Identificar los criterios para la disminución progresiva frente al cese abrupto.
  • Describir los métodos para evaluar la recuperación del eje HPA.

Principales métodos:

  • Revisión de la literatura sobre el retiro de los glucocorticoides.
  • Directrices clínicas para la evaluación del eje HPA.
  • Estudios de caso que ilustran diferentes protocolos para dejar de fumar.

Principales resultados:

  • El cese abrupto es seguro para los usuarios de glucocorticoides a corto plazo.
  • El uso prolongado requiere una disminución gradual para evitar la insuficiencia adrenal.
  • La prueba de cortisol en suero por la mañana puede guiar el cese en algunos pacientes.
  • Las pruebas de estimulación de la hormona adrenocorticotrófica pueden ser necesarias para la disfunción persistente del eje HPA.

Conclusiones:

  • La duración del tratamiento con glucocorticoides determina la estrategia de cese.
  • La evaluación del eje HPA es crucial para la retirada segura de glucocorticoides después de un uso prolongado.
  • El seguimiento y las pruebas individualizadas del paciente garantizan resultados óptimos.