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相关概念视频

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

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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...
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Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

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Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
334
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids01:25

Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

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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...
385
COPD: Management Using Bronchodilators and Corticosteroids01:26

COPD: Management Using Bronchodilators and Corticosteroids

307
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
307
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

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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...
267
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

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The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
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停止使用葡萄糖皮质类药物的实用指南

Faran Khalili1,2, Morton G Burt1,2

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

Australian prescriber
|August 27, 2025
PubMed
概括

短期使用的葡萄糖皮质类药物可以突然停止. 长期使用需要逐渐减少,以防止上腺功能衰竭,对某些患者进行皮质醇测试指导停止使用.

科学领域:

  • 内分泌学
  • 药理学

背景情况:

  • 葡萄皮质激素是常见的处方药.
  • 短期使用 (少于3-4周) 通常不需要逐渐减少剂量.
  • 长期使用可能导致下丘脑- 垂体- 上腺 (HPA) 轴抑制.

研究的目的:

  • 概述停止使用葡萄糖皮质类药物的管理方法.
  • 确定逐渐减少与突然停止的标准.
  • 描述评估HPA轴回收的方法.

主要方法:

  • 关于葡萄糖皮质激素戒断的文献综述
  • 对HPA轴的临床指导方针
  • 展示不同戒烟方案的案例研究.

主要成果:

  • 对于短期使用葡萄糖皮质激素来说,突然停止使用是安全的.
  • 长期使用需要逐渐减少,以避免上腺功能衰竭.
  • 在某些患者中,早晨的血清皮质醇测试可以指导戒烟.
  • 对于持续的HPA轴功能障碍,可能需要进行上皮质激素刺激测试.

结论:

关键词:
在HPA轴上上腺功能衰竭药物逐渐减少葡萄糖皮质类药物戒断综合征葡萄糖皮质类药物

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  • 葡萄糖皮质激素治疗的持续时间决定了停止治疗的策略.
  • 在长期使用后,对HPA轴的评估对于安全地停止使用葡萄糖皮质激素至关重要.
  • 个性化的患者监测和测试确保了最佳的结果.