[局部使用的皮质类固醇的全身副作用]
Wieland D Müskens1,2, Marianne K Dees3, M M L Stikkelbroeck4
1Radboudumc, afd. Apotheek, Nijmegen.
Nederlands tijdschrift voor geneeskunde
|October 9, 2024
概括
局部皮质类固醇可以引起全身副作用,医生往往无法识别. 识别患者的风险因素并考虑替代治疗方法可以减轻这些不良事件.
科学领域:
- 药理学 药理学是指药理学的学科.
- 内分泌学 在内分泌学.
- 临床医学 临床医学
背景情况:
- 皮质类固醇经常局部施用,以尽量减少全身暴露和相关的副作用.
- 然而,局部使用的皮质类固醇的全身副作用潜力往往被低估.
- 这种缺乏意识可能导致这些不良事件的识别和治疗延迟.
研究的目的:
- 为了突出局部皮质类固醇药物给药造成的全身副作用的风险未被充分认识到.
- 强调识别系统性皮质类固醇毒性风险因素的重要性.
- 为了告知临床实践关于局部皮质类固醇治疗的管理.
主要方法:
- 关于局部皮质类固醇施用和全身副作用的现有文献的审查.
- 对影响系统吸收和毒性因素的分析.
- 鉴定具有较高系统风险概况的特定皮质类固醇剂.
主要成果:
- 所有形式的局部施用皮质类固醇都会带来全身副作用的风险.
- 系统性副作用的发病率数据是有限的,因为未得到充分承认.
- 个人风险因许多因素而有很大差异,包括使用的特定药物.
结论:
- 医生需要提高对局部皮质类固醇使用潜在的全身副作用的认识.
- 确定患者特异性风险因素对于主动管理至关重要.
- 应考虑替代治疗选择,当诸如流他吸入器或布德塞尼德鼻喷雾剂等药物存在高风险时.
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