在非处方药关节炎补充剂中隐藏性葡萄皮质类药物的影响
Kevin S Wei1, Miguel O De La Torre1, Antonio Flores1
1Department of Medicine, Los Angeles General Medical Center, Los Angeles, CA 90033, USA.
Journal of the Endocrine Society
|January 10, 2025
概括
在12名患者中,非处方药的关节炎补充剂含有隐藏的葡萄皮质激素导致上腺功能障碍,包括库辛综合征和上腺功能不充分. 许多人需要替代类固醇,突出了未标记补充剂的风险.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 无处方药 (OTC) 保健补充剂可能含有未申报的葡萄皮质激素,导致iatrogenic上腺功能障碍.
- 之前的报道存在,但关于特定关节炎补充剂的综合数据有限.
研究的目的:
- 介绍一系列患有因OTC关节炎补充剂含有未披露的葡萄糖皮质类药物而导致阳性上腺功能障碍的病例.
- 描述受影响个体中库辛综合征 (CS) 和上腺功能不足 (AI) 的临床表现,诊断结果和管理.
主要方法:
- 在城市安全网医疗中心对12名被评估为上腺功能障碍的患者进行了回顾性病例系列.
- 对临床数据的分析,包括症状,身体发现,实验室结果 (皮质醇水平,共热素测试) 和治疗结果.
- 审查有关类似案件的现有文献.
主要成果:
- 确定了使用OTC关节炎补充剂 (Artri King,Ardosons,Ajo Rey) 的12名患者.
- 83.3%的人出现了库辛综合征 (例如,月球面,中心脂肪) 和66.7%的人出现了上腺功能不足症状 (例如,恶心,疲劳).
- 83.3%的患者最初需要葡萄糖皮质激素替代剂,而4名患者的持续需求.
结论:
- 非处方关节炎补充剂可以隐蔽地含有葡萄糖皮质类药物,导致显著的上腺功能障碍 (CS和AI).
- 该系列提供了关于临床表现和管理的广泛数据,超过了先前的报告.
- 对补充剂来源的警识别和在停止治疗时识别AI对于患者护理至关重要.
相关概念视频
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
95
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
95
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
217
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
217
01:19Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
152
α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
Acarbose and miglitol are...
152
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
141
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
141
01:29Drugs for Treatment of Ulcerative Colitis in IBD
119
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
119
01:02Prescription, Nonprescription and Orphan Drugs
686
Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
686