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Different Steroid Replacement Medications - CSRF - Cushing's Support & Research Foundation

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Hydrocortisone vs prednisone



 

For general information, Learn About Clinical Studies. Layout table for eligibility information Ages Eligible for Study: 18 Years to 85 Years Adult, Older Adult Sexes Eligible for Study: All Sampling Method: Non-Probability Sample Study Population Individuals with either primary or secondary adrenal insufficiency who are currently receiving glucocorticoid replacement therapy with hydrocortisone or prednisolone.

Criteria Inclusion Criteria:. We're building a better ClinicalTrials. Check it out and tell us what you think! Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information. Search for terms. Save this study. Warning You have reached the maximum number of saved studies Listing a study does not mean it has been evaluated by the U. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating.

Read our disclaimer for details. Last Update Posted : August 15, See Contacts and Locations. View this study on Beta. Study Description. This study is designed to collect data on individuals with adrenal insufficiency who are changing treatments from hydrocortisone to prednisolone, or vice versa. It will compare anthropometric, biochemical and subjective health outcomes between both treatments.

Detailed Description:. Drug Information available for: Hydrocortisone acetate Hydrocortisone Prednisolone Prednisolone acetate Methylprednisolone acetate Methylprednisolone Prednisolone sodium phosphate Hydrocortisone sodium succinate Prednisolone phosphate Hydrocortisone cypionate Prednisolone sodium succinate Methylprednisolone sodium succinate Hydrocortisone valerate Hydrocortisone probutate Proctofoam-HC.

FDA Resources. There is no specific intervention other than an individual changing their treatment as part of their usual care. Outcome Measures. Secondary Outcome Measures : Heart rate [ Time Frame: Minimum 4 months of stable treatment ] recording observations- heart rate. Symptoms include nausea, lethargy, muscle pain, headaches etc. Eligibility Criteria. Individuals with either primary or secondary adrenal insufficiency who are currently receiving glucocorticoid replacement therapy with hydrocortisone or prednisolone.

Inclusion Criteria: Aged 18 - 85 years Male or female Diagnosed with adrenal insufficiency AI for over 6 months according to standard diagnostic criteria Established on stable hydrocortisone or prednisolone replacement, dose not altered for at least 4 months Individuals taking other hormone replacements are accepted providing that their replacement doses have not altered for at least 3 months; Individuals who are able and willing to give written informed consent to participate in the study Exclusion Criteria: Individuals who are unable to give informed consent Pregnancy determined by patients self-reporting pregnancy status Patients using the combined oral contraceptive pill.

Contacts and Locations. Viral croup is a common childhood disease. In fact, it is the most common form of upper airway obstruction in children six months to six years of age. Corticosteroids have been studied in the management of croup for the past 30 years, but their use in this condition is controversial.

The use of steroids in children with croup is associated with significant clinical improvement at about 12 hours post-treatment and results in less endotracheal intubation. Most current research focuses on outpatient use of corticosteroids in the treatment of moderate and severe croup.

Some authors have found that routine use of steroids reduces the need for hospitalization. Although budenoside is well tolerated with minimal side effects because of limited systemic availability, it is not yet available for use in the United States except in a nasal form.

A single intramuscular injection of 0. Therefore, intramuscular corticosteroid treatment should be considered in patients with moderate croup before discharge from the emergency department when outpatient therapy is entertained. Pneumocystis carinii pneumonia PCP is a leading cause of morbidity and mortality in patients infected with human immunodeficiency virus HIV.

This clinically significant complication of HIV infection occurs in 60 to 80 percent of patients with acquired immunodeficiency syndrome not receiving prophylaxis 14 and causes death in approximately 25 percent of its victims. Since the late s, adjunctive treatment with corticosteroids has been documented in case reports and research studies with favorable clinical results, and it is currently endorsed by the National Institutes of Health as a standard therapy.

Documented benefits of corticosteroid therapy in patients with PCP include reduced morbidity and mortality, decreased need for mechanical ventilation assistance and a reduced long-term decline in pulmonary function or exercise tolerance. Progression of other opportunistic infections associated with HIV infection as a result of the immunosuppressive effects of corticosteroids is a risk that must be considered.

While some studies report only minor complications associated with steroid therapy, such as reactivation of localized herpetic lesions, 18 others have reported an increased incidence of infection and cancer. Based on the benefits and risks of adjunctive corticosteroid therapy, the current recommendations are not intended for all patients but only for those with confirmed or suspected HIV and PCP infection who are at high risk of respiratory failure and death.

Patients at risk include those with an arterial oxygen pressure of less than 70 mm Hg or an arterial-alveolar gradient of more than 35 mm Hg. The recommended dosing regimen is oral prednisone, 40 mg twice daily for five days, then 40 mg once daily for five days, then 20 mg daily for the duration of the anti-pneumocystis therapy. Methylprednisolone, given at 75 percent of the oral prednisone dosage, can be substituted if parenteral therapy is necessary. A confirmatory diagnosis of PCP and HIV infection should be obtained, and other diseases, such as tuberculosis and cryptococcosis, should be ruled out before steroid therapy is begun.

Further investigation is required to determine the appropriate use and benefits of steroid therapy when the patient has concomitant life-threatening infections and when the patient has already received more than three days of anti-pneumocystis therapy and has developed significant hypoxia. Hyperthyroidism is a common disease affecting around 2 percent of women and 0.

The amount of benefit and the effect on patient outcome in this circumstance is not yet known. Graves' eye disease is treated by first normalizing the thyroid function and then administering diuretics and systemic glucocorticoids. Other causes of hyperthyroidism that may be treated with corticosteroids are subacute thyroiditis and thyroid storm. Hyperthyroid disease related to thyroiditis is usually mild and self-limited.

Beta blockers may be used to treat symptoms. In subacute thyroiditis, non-steroidal anti-inflammatory drugs or corticosteroids can be used to relieve thyroid pain and tenderness. Thyroid storm is a life-threatening condition of the hyperthyroid state.

Corticosteroids are used as adjuvant analgesics for pain in cancer patients and patients with neuropathic pain such as herpes zoster—related neuropathy, spinal cord compression and pain following oral surgery.

Prednisone, at a dosage of 7. Patients with nerve compression pain or pain resulting from increased intracranial pressure showed a better response when compared with patients with other pain syndromes. Perioperative use of corticosteroids has been advocated to reduce pain and decrease edema and trismus following oral surgical procedures. The most significant improvement occurs in the treatment of postoperative edema. Dosages of prednisone between 40 and 80 mg per day can be used.

Maximal benefit has been achieved after third-molar extraction, although some benefit has been reported after other surgeries. Some evidence indicates that combining corticosteroids with acyclovir Zovirax will decrease the duration of zoster-associated pain. Systemic treatment with corticosteroids such as prednisone, at 40 mg per day for three weeks, decreases the proportion of patients affected by postherpetic neuralgia, especially pain occurring six to 12 weeks after onset.

Alcoholic hepatitis is a chronic, progressive and often fatal disease. Treatment has generally been supportive. Meta-analysis of studies from to supports the finding that patients with acute severe alcoholic hepatitis and hepatic encephalopathy, without gastrointestinal bleeding, benefit from a trial of corticosteroid therapy.

Further clinical trials were recommended to clarify the role of steroids in the treatment of alcoholic hepatitis. Bacterial meningitis is a serious disease that may result in death or permanent neurologic complications such as seizures, paralysis or sensorineural hearing loss. These produce inflammatory components such as cytokines, which lead to meningeal inflammation and increased intracranial pressure. Studies show that potent corticosteroids, such as dexamethasone, combined with appropriate antibiotics reduce the risk of acquired sensorineural deafness and the incidence of other neurologic sequelae in meningitis caused by Haemophilus influenzae.

The drug was administered in a dosage of 0. Corticosteroids may also be used in the treatment of tuberculous meningitis. In one randomized, controlled study 55 involving 47 patients in India, dexamethasone was found to be useful as an adjunct treatment in cases of tuberculous meningitis, especially in patients with severe disease. A more recent randomized trial 56 using prednisone in children with tuberculous meningitis showed that prednisone in a dosage of 2 to 4 mg per kg per day for one month improved survival rate and intellectual outcome.

Table 4 57 lists other unlabeled uses of corticosteroids. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.

Actions and Side Effects. Edema Decreased salt intake Increased potassium excretion Potassium supplements may be necessary. Increased calcium excretion Use with caution in patients at increased risk of developing osteoporosis; calcium supplements may be necessary, especially in postmenopausal women.

Gastrointestinal Gastric irritation Take with meals to prevent gastric upset. Endocrine Hypercortisolism Cushingoid state , secondary adrenal insufficiency Associated with long-term use even at lower dosages Menstrual difficulties, including amenorrhea and postmenopausal bleeding Precipitation of diabetes mellitus Glucose intolerance, hyperglycemia In patients with diabetes, increased dosages of insulin or oral hypoglycemic agent and changes in diet should be expected.

Cardiovascular Hypertension Use with extreme caution in patients with recent myocardial infarction because of an apparent association with left ventricular free-wall rupture. Thromboembolism Use with caution in patients with thromboembolic disorders because of reports of rare increased blood coagulability. Thrombophlebitis CHF exacerbation Ocular Posterior subcapsular cataracts Prolonged use may result in increased intraocular pressure or damaged ocular nerve.

❿  


Hydrocortisone vs prednisone. Different Steroid Replacement Medications



  Hydrocortisone showed advantages over prednisone in improving liver function, and prednisone exhibited significantly lower risk of edema. Comparing Hydrocortisone Topical vs Prednisone ; Hydrocortisone topical has an average rating of out of 10 from a total of 57 ratings on localhost 57% of. and has a longer duration of action, perhaps 12 hours or more. Dexamethasone is 40 to 50 times more potent than hydrocortisone and even longer-acting, 18 to 24 hours. Both of these glucocorticoids are given when a prolonged action is desired.     ❾-50%}

 

Hydrocortisone vs prednisone -



    The most significant improvement occurs in the treatment of postoperative edema. Muscle pain or weakness, muscle wasting, pathologic long bone or vertebral compression fractures, atrophy of protein matrix of bone, aseptic necrosis of femoral or humeral heads. Contraindicated in patients with systemic fungal infections except to control drug reactions associated with amphotericin B [Fungizone] therapy. The risk of these effects increases with increased dosages and prolonged use; use of antiulcer agents is suggested only in patients requiring long-term steroid therapy at high dosages; use with caution or avoid in patients with GI diseases in which perforation or hemorrhage are potential risks.

It will compare anthropometric, biochemical and subjective health outcomes between both treatments. Detailed Description:. Drug Information available for: Hydrocortisone acetate Hydrocortisone Prednisolone Prednisolone acetate Methylprednisolone acetate Methylprednisolone Prednisolone sodium phosphate Hydrocortisone sodium succinate Prednisolone phosphate Hydrocortisone cypionate Prednisolone sodium succinate Methylprednisolone sodium succinate Hydrocortisone valerate Hydrocortisone probutate Proctofoam-HC.

FDA Resources. There is no specific intervention other than an individual changing their treatment as part of their usual care. Outcome Measures. Secondary Outcome Measures : Heart rate [ Time Frame: Minimum 4 months of stable treatment ] recording observations- heart rate.

Symptoms include nausea, lethargy, muscle pain, headaches etc. Eligibility Criteria. Individuals with either primary or secondary adrenal insufficiency who are currently receiving glucocorticoid replacement therapy with hydrocortisone or prednisolone. Inclusion Criteria: Aged 18 - 85 years Male or female Diagnosed with adrenal insufficiency AI for over 6 months according to standard diagnostic criteria Established on stable hydrocortisone or prednisolone replacement, dose not altered for at least 4 months Individuals taking other hormone replacements are accepted providing that their replacement doses have not altered for at least 3 months; Individuals who are able and willing to give written informed consent to participate in the study Exclusion Criteria: Individuals who are unable to give informed consent Pregnancy determined by patients self-reporting pregnancy status Patients using the combined oral contraceptive pill.

Contacts and Locations. Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials. More Information. National Library of Medicine U. National Institutes of Health U. Department of Health and Human Services. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Adrenal Insufficiency. Glucocorticoids are primarily regulated by corticotropin ACTH and can have anti-inflammatory effects, as well as several metabolic and immunogenic effects, on the body.

While several corticosteroid agents possess properties of both hormones, fludrocortisone is most commonly used for its mineralocorticoid activity and hydrocortisone, cortisone, prednisone and prednisolone are used for their glucocorticoid effects. Table 1 summarizes the relative potencies of the hormonal effects in addition to providing equivalent doses.

Therapeutic effects of steroids can often parallel undesirable side effects, especially when high doses and long-term therapy are required. By anticipating the potential side effects and implementing preventive measures where possible Table 2 , 1 — 4 patients can obtain maximum benefits with minimum adverse effects.

The dosage range for steroids is wide, and patient response is variable. A low or maintenance dosage is approximately 0. Short-term, low-dose steroid therapy rarely results in any of the adverse effects listed in Table 2.

In long-term therapy, alternate-day administration should be considered. Some disease states, however, such as temporal arteritis and systemic lupus erythematosus, may not be adequately controlled with alternate-day therapy.

Doubling the dosage and administering the drug every other day in the morning more closely mimics the endogenous corticosteroid circadian rhythm. This form of administration enables the patient to experience the therapeutic effects while side effects are minimized.

Viral croup is a common childhood disease. In fact, it is the most common form of upper airway obstruction in children six months to six years of age. Corticosteroids have been studied in the management of croup for the past 30 years, but their use in this condition is controversial. The use of steroids in children with croup is associated with significant clinical improvement at about 12 hours post-treatment and results in less endotracheal intubation. Most current research focuses on outpatient use of corticosteroids in the treatment of moderate and severe croup.

Some authors have found that routine use of steroids reduces the need for hospitalization. Although budenoside is well tolerated with minimal side effects because of limited systemic availability, it is not yet available for use in the United States except in a nasal form.

A single intramuscular injection of 0. Therefore, intramuscular corticosteroid treatment should be considered in patients with moderate croup before discharge from the emergency department when outpatient therapy is entertained. Pneumocystis carinii pneumonia PCP is a leading cause of morbidity and mortality in patients infected with human immunodeficiency virus HIV. This clinically significant complication of HIV infection occurs in 60 to 80 percent of patients with acquired immunodeficiency syndrome not receiving prophylaxis 14 and causes death in approximately 25 percent of its victims.

Since the late s, adjunctive treatment with corticosteroids has been documented in case reports and research studies with favorable clinical results, and it is currently endorsed by the National Institutes of Health as a standard therapy.

Documented benefits of corticosteroid therapy in patients with PCP include reduced morbidity and mortality, decreased need for mechanical ventilation assistance and a reduced long-term decline in pulmonary function or exercise tolerance.

Progression of other opportunistic infections associated with HIV infection as a result of the immunosuppressive effects of corticosteroids is a risk that must be considered. While some studies report only minor complications associated with steroid therapy, such as reactivation of localized herpetic lesions, 18 others have reported an increased incidence of infection and cancer.

Based on the benefits and risks of adjunctive corticosteroid therapy, the current recommendations are not intended for all patients but only for those with confirmed or suspected HIV and PCP infection who are at high risk of respiratory failure and death.

Patients at risk include those with an arterial oxygen pressure of less than 70 mm Hg or an arterial-alveolar gradient of more than 35 mm Hg. The recommended dosing regimen is oral prednisone, 40 mg twice daily for five days, then 40 mg once daily for five days, then 20 mg daily for the duration of the anti-pneumocystis therapy. Methylprednisolone, given at 75 percent of the oral prednisone dosage, can be substituted if parenteral therapy is necessary.

A confirmatory diagnosis of PCP and HIV infection should be obtained, and other diseases, such as tuberculosis and cryptococcosis, should be ruled out before steroid therapy is begun.

Further investigation is required to determine the appropriate use and benefits of steroid therapy when the patient has concomitant life-threatening infections and when the patient has already received more than three days of anti-pneumocystis therapy and has developed significant hypoxia.

Hyperthyroidism is a common disease affecting around 2 percent of women and 0. The amount of benefit and the effect on patient outcome in this circumstance is not yet known. Graves' eye disease is treated by first normalizing the thyroid function and then administering diuretics and systemic glucocorticoids.

Other causes of hyperthyroidism that may be treated with corticosteroids are subacute thyroiditis and thyroid storm. Hyperthyroid disease related to thyroiditis is usually mild and self-limited.

Beta blockers may be used to treat symptoms. In subacute thyroiditis, non-steroidal anti-inflammatory drugs or corticosteroids can be used to relieve thyroid pain and tenderness. Thyroid storm is a life-threatening condition of the hyperthyroid state. Your body could stop making its own cortisol once it gets used to Cortef Hydrocortisone. If so, you'll likely have to keep taking Cortef Hydrocortisone for a really long time. Depending on why your doctor prescribed Cortef Hydrocortisone to you, corticosteroids can have different effects on your body.

Deltasone prednisone can cause unwanted side effects such as mood changes, trouble sleeping, and increase in blood pressure as well as blood sugar at higher doses. Long-term use can cause problems to your skin, bones, eyes, and place you at a higher risk for infections. If Deltasone prednisone is used for more than 2 weeks, you will need to work with a doctor to taper off the medicine by gradually decreasing the dose.

Deltasone prednisone can harm an unborn baby, so it's not a good option for pregnant women. Inflammation Immune system problems Steroid hormone replacement Endocrine system disorders Multiple sclerosis flare-up Lupus Nausea and vomiting caused by chemotherapy Lung disease Prostate cancer. Learn more. Not enough review data. Leave a review.

Corticosteroids were first used in clinical practice in for the treatment of rheumatoid arthritis. Indications since then have spanned multiple specialties and organ systems, including dermatology, rheumatology, immunology and oncology. This review covers practical uses of steroids as well as current and frequently overlooked clinical applications that may be helpful to family physicians.

If physicians understand the composition and physiologic effects of corticosteroid agents, appropriate drug selection can be made and inappropriate or problematic uses can be avoided. Corticosteroid agents mimic the endogenous steroid hormones produced in the adrenal cortex—mineralocorticoid aldosterone and glucocorticoid cortisol.

Mineralocorticoids are primarily regulated by the renin-angiotensin system and possess salt-retaining properties. Glucocorticoids are primarily regulated by corticotropin ACTH and can have anti-inflammatory effects, as well as several metabolic and immunogenic effects, on the body. While several corticosteroid agents possess properties of both hormones, fludrocortisone is most commonly used for its mineralocorticoid activity and hydrocortisone, cortisone, prednisone and prednisolone are used for their glucocorticoid effects.

Table 1 summarizes the relative potencies of the hormonal effects in addition to providing equivalent doses. Therapeutic effects of steroids can often parallel undesirable side effects, especially when high doses and long-term therapy are required.

By anticipating the potential side effects and implementing preventive measures where possible Table 21 — 4 patients can obtain maximum benefits with minimum adverse effects.

The dosage range for steroids is wide, and patient response is variable. A low or maintenance dosage is approximately 0. Short-term, low-dose steroid therapy rarely results in any of the adverse effects listed in Table 2.

In long-term therapy, alternate-day administration should be considered. Some disease states, however, such as temporal arteritis and systemic lupus erythematosus, may not be adequately controlled with alternate-day therapy. Doubling the dosage and administering the drug every other day in the morning more closely mimics the endogenous corticosteroid circadian rhythm. This form of administration enables the patient to experience the therapeutic effects while side effects are minimized.

Viral croup is a common childhood disease. In fact, it is the most common form of upper airway obstruction in children six months to six years of age. Corticosteroids have been studied in the management of croup for the past 30 years, but their use in this condition is controversial. The use of steroids in children with croup is associated with significant clinical improvement at about 12 hours post-treatment and results in less endotracheal intubation.

Most current research focuses on outpatient use of corticosteroids in the treatment of moderate and severe croup. Some authors have found that routine use of steroids reduces the need for hospitalization.

Although budenoside is well tolerated with minimal side effects because of limited systemic availability, it is not yet available for use in the United States except in a nasal form. A single intramuscular injection of 0. Therefore, intramuscular corticosteroid treatment should be considered in patients with moderate croup before discharge from the emergency department when outpatient therapy is entertained. Pneumocystis carinii pneumonia PCP is a leading cause of morbidity and mortality in patients infected with human immunodeficiency virus HIV.

This clinically significant complication of HIV infection occurs in 60 to 80 percent of patients with acquired immunodeficiency syndrome not receiving prophylaxis 14 and causes death in approximately 25 percent of its victims.

Since the late s, adjunctive treatment with corticosteroids has been documented in case reports and research studies with favorable clinical results, and it is currently endorsed by the National Institutes of Health as a standard therapy. Documented benefits of corticosteroid therapy in patients with PCP include reduced morbidity and mortality, decreased need for mechanical ventilation assistance and a reduced long-term decline in pulmonary function or exercise tolerance.

Progression of other opportunistic infections associated with HIV infection as a result of the immunosuppressive effects of corticosteroids is a risk that must be considered. While some studies report only minor complications associated with steroid therapy, such as reactivation of localized herpetic lesions, 18 others have reported an increased incidence of infection and cancer.

Based on the benefits and risks of adjunctive corticosteroid therapy, the current recommendations are not intended for all patients but only for those with confirmed or suspected HIV and PCP infection who are at high risk of respiratory failure and death.

Patients at risk include those with an arterial oxygen pressure of less than 70 mm Hg or an arterial-alveolar gradient of more than 35 mm Hg.

The recommended dosing regimen is oral prednisone, 40 mg twice daily for five days, then 40 mg once daily for five days, then 20 mg daily for the duration of the anti-pneumocystis therapy. Methylprednisolone, given at 75 percent of the oral prednisone dosage, can be substituted if parenteral therapy is necessary.

A confirmatory diagnosis of PCP and HIV infection should be obtained, and other diseases, such as tuberculosis and cryptococcosis, should be ruled out before steroid therapy is begun. Further investigation is required to determine the appropriate use and benefits of steroid therapy when the patient has concomitant life-threatening infections and when the patient has already received more than three days of anti-pneumocystis therapy and has developed significant hypoxia.

Hyperthyroidism is a common disease affecting around 2 percent of women and 0. The amount of benefit and the effect on patient outcome in this circumstance is not yet known. Graves' eye disease is treated by first normalizing the thyroid function and then administering diuretics and systemic glucocorticoids.

Other causes of hyperthyroidism that may be treated with corticosteroids are subacute thyroiditis and thyroid storm. Hyperthyroid disease related to thyroiditis is usually mild and self-limited. Beta blockers may be used to treat symptoms. In subacute thyroiditis, non-steroidal anti-inflammatory drugs or corticosteroids can be used to relieve thyroid pain and tenderness.

Thyroid storm is a life-threatening condition of the hyperthyroid state. Corticosteroids are used as adjuvant analgesics for pain in cancer patients and patients with neuropathic pain such as herpes zoster—related neuropathy, spinal cord compression and pain following oral surgery.

Prednisone, at a dosage of 7. Patients with nerve compression pain or pain resulting from increased intracranial pressure showed a better response when compared with patients with other pain syndromes. Perioperative use of corticosteroids has been advocated to reduce pain and decrease edema and trismus following oral surgical procedures. The most significant improvement occurs in the treatment of postoperative edema. Dosages of prednisone between 40 and 80 mg per day can be used.

Maximal benefit has been achieved after third-molar extraction, although some benefit has been reported after other surgeries. Some evidence indicates that combining corticosteroids with acyclovir Zovirax will decrease the duration of zoster-associated pain.

Systemic treatment with corticosteroids such as prednisone, at 40 mg per day for three weeks, decreases the proportion of patients affected by postherpetic neuralgia, especially pain occurring six to 12 weeks after onset. Alcoholic hepatitis is a chronic, progressive and often fatal disease. Treatment has generally been supportive. Meta-analysis of studies from to supports the finding that patients with acute severe alcoholic hepatitis and hepatic encephalopathy, without gastrointestinal bleeding, benefit from a trial of corticosteroid therapy.

Further clinical trials were recommended to clarify the role of steroids in the treatment of alcoholic hepatitis. Bacterial meningitis is a serious disease that may result in death or permanent neurologic complications such as seizures, paralysis or sensorineural hearing loss.

These produce inflammatory components such as cytokines, which lead to meningeal inflammation and increased intracranial pressure. Studies show that potent corticosteroids, such as dexamethasone, combined with appropriate antibiotics reduce the risk of acquired sensorineural deafness and the incidence of other neurologic sequelae in meningitis caused by Haemophilus influenzae.

The drug was administered in a dosage of 0. Corticosteroids may also be used in the treatment of tuberculous meningitis. In one randomized, controlled study 55 involving 47 patients in India, dexamethasone was found to be useful as an adjunct treatment in cases of tuberculous meningitis, especially in patients with severe disease. A more recent randomized trial 56 using prednisone in children with tuberculous meningitis showed that prednisone in a dosage of 2 to 4 mg per kg per day for one month improved survival rate and intellectual outcome.

Table 4 57 lists other unlabeled uses of corticosteroids. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.

Actions and Side Effects. Edema Decreased salt intake Increased potassium excretion Potassium supplements may be necessary. Increased calcium excretion Use with caution in patients at increased risk of developing osteoporosis; calcium supplements may be necessary, especially in postmenopausal women.

Gastrointestinal Gastric irritation Take with meals to prevent gastric upset. Endocrine Hypercortisolism Cushingoid statesecondary adrenal insufficiency Associated with long-term use even at lower dosages Menstrual difficulties, including amenorrhea and postmenopausal bleeding Precipitation of diabetes mellitus Glucose intolerance, hyperglycemia In patients with diabetes, increased dosages of insulin or oral hypoglycemic agent and changes in diet should be expected.

Cardiovascular Hypertension Use with extreme caution in patients with recent myocardial infarction because of an apparent association with left ventricular free-wall rupture. Thromboembolism Use with caution in patients with thromboembolic disorders because of reports of rare increased blood coagulability.

Thrombophlebitis CHF exacerbation Ocular Posterior subcapsular cataracts Prolonged use may result in increased intraocular pressure or damaged ocular nerve.

Use in patients with ocular herpes simplex may cause corneal perforation. Glaucoma May enhance secondary fungal or viral infections of the eye Musculoskeletal Muscle pain or weakness, muscle wasting, pathologic long bone or vertebral compression fractures, atrophy of protein matrix of bone, aseptic necrosis of femoral or humeral heads Use with caution in patients prone to development of osteoporosis; risk versus benefit should be reassessed if osteoporosis develops; elderly, debilitated or poorly nourished patients may be more prone to these effects.

Supplementation with calcium, 1, mg per day, and vitamin D, IU per day, is recommended. Neuropsychiatric Headache, vertigo, seizures, increased motor activity, insomnia, mood changes, psychosis Use with caution in patients with convulsive or psychiatric disorders. Use may aggravate preexisting psychiatric conditions. Steroid-induced psychosis is dose-related, occurs within 15 to 30 days of therapy and is treatable if steroid therapy must be continued.

Pseudotumor cerebri reported during withdrawal. Other Increased susceptibility to infections, masked symptoms of infections Contraindicated in patients with systemic fungal infections except to control drug reactions associated with amphotericin B [Fungizone] therapy. Do not use live virus vaccinations during therapy.

Reactions to skin tests may be suppressed. In most patients, endogenous corticosteroid secretions are equivalent to 5 to 7. Recommended tapering schedules Tapering the dosage over 2 months or more may be necessary for patients on prolonged treatment more than 1 year. Depending on dosage, duration of therapy and risk of systemic disease, decrease dosage by the equivalent of 2. Then perform a challenge to determine the extent of HPA axis recovery.

Depending on the results and patient's symptoms, therapy may be discontinued or a slower taper considered. If symptoms do not subside when steroid dosage is adjusted, other causes must be considered.

In certain severe illnesses or during acute flare ups, daily dosing may be re-initiated. Pneumocystis carinii Pneumonia. Pain Management. Alcoholic Hepatitis.

Once daily prednisolone is another regimen in clinical use and now prescribed at less than 5mg daily. It has a longer duration of action and a. Prednisone and hydrocortisone are synthetic corticosteroids used for suppressing the immune system and inflammation. Both drugs are used to treat many. Prednisone and hydrocortisone are synthetic corticosteroids used for suppressing the immune system and inflammation. Both drugs are used to treat many. Prednisone and methylprednisolone, which are intermediate-acting products, are four to five times more potent than hydrocortisone. Dexamethasone. Hydrocortisone showed advantages over prednisone in improving liver function, and prednisone exhibited significantly lower risk of edema. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Treatment has generally been supportive. A confirmatory diagnosis of PCP and HIV infection should be obtained, and other diseases, such as tuberculosis and cryptococcosis, should be ruled out before steroid therapy is begun.

Cortef Hydrocortisone is identical to an essential hormone that humans produce and has been proven to work safely. Deltasone prednisone is effective for controlling allergic reactions and conditions involving an overactive immune system. It can quickly make you feel better, but Deltasone prednisone can cause serious complications and side effects if taken for a long time. Compare Cortef vs. Cortef Hydrocortisone Prescription only.

Deltasone prednisone Prescription only. Cortef Hydrocortisone lowers inflammation, suppresses the immune system, and replaces low cortisol. Calms down your immune system.

Normal doses of hydrocortisone have been safely and successfully used for over 60 years. It's especially good for people using it as a long-term cortisol supplement. Cortef Hydrocortisone converts into cortisol, a natural hormone, which will not interfere with other medications you may be taking.

Taking a dose of Cortef Hydrocortisone in the evening doesn't affect your ability to sleep. At safe doses, Cortef Hydrocortisone can actually increase your body's ability to fight infection.

Deltasone prednisone effectively treats a variety of conditions involving the immune system. Can help improve energy and stimulate your appetite. Works quickly to provide relief for swelling, rash, asthma attacks, and pain. Good long-term treatment option for autoimmune disorders. Deltasone prednisone is available in a generic form. In the first few weeks, your doctor might adjust the dose of Cortef Hydrocortisone multiple times.

You may be at an increased risk of infection if you take high doses of Cortef Hydrocortisone , or if you take it in combination with other immunosuppressive medications. Your body could stop making its own cortisol once it gets used to Cortef Hydrocortisone. If so, you'll likely have to keep taking Cortef Hydrocortisone for a really long time.

Depending on why your doctor prescribed Cortef Hydrocortisone to you, corticosteroids can have different effects on your body. Deltasone prednisone can cause unwanted side effects such as mood changes, trouble sleeping, and increase in blood pressure as well as blood sugar at higher doses.

Long-term use can cause problems to your skin, bones, eyes, and place you at a higher risk for infections. If Deltasone prednisone is used for more than 2 weeks, you will need to work with a doctor to taper off the medicine by gradually decreasing the dose. Deltasone prednisone can harm an unborn baby, so it's not a good option for pregnant women. Inflammation Immune system problems Steroid hormone replacement Endocrine system disorders Multiple sclerosis flare-up Lupus Nausea and vomiting caused by chemotherapy Lung disease Prostate cancer.

Learn more. Not enough review data. Leave a review. Adrenal suppression HPA axis suppression. Physicial Dependence. Learn more about Cortef Hydrocortisone Learn more about Deltasone prednisone.



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