Corticosteroid

Giving corticosteroid
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Suppressive action of corticosteroid on cortisol secretion is least when it is given as a SINGLE dose in the MORNING.
(Therefore, give corticosteriod in the morning as a single dose and not at night)

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HPA(hypothalamic-pituitary-adrenal axis) suppression likely ? Patients who have received glucocorticoids who meet the following

criteria are presumed to have HPA suppression:

    -Anyone who has received a glucocorticoid dose comparable to more than 20 mg of prednisone a day for more than three weeks.
    -Anyone who has received an evening/bedtime dose of prednisone for more than a few weeks.
    -Any patient who has a Cushingoid appearance
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Tapering regimen

    10 mg/day every one to two weeks at an initial dose above 60 mg of prednisone or equivalent per day.
    5 mg/day every one to two weeks at prednisone doses between 60 and 20 mg/day.
    2.5 mg/day every one to two weeks at prednisone doses between 19 and 10 mg/day.
    1 mg/day every one to two weeks at prednisone doses between 9 and 5 mg/day.
    0.5 mg/day every one to two weeks at prednisone doses below 5 mg/day. This can be achieved by alternating daily doses, eg, 5

mg on day 1 and 4 mg on day 2. (i.e. 1 mg/ every 2 days)

[..-60-20-10-5-..]
[10-5-2.5-1-0.5]
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signs of adrenal insufficiency:
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shock
non-specific malaise

side effect of corticosteroid
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mem tip: 오잉 (내가 왜) 고혈압에 당뇨지?

-osteoporosis
-infection
-hypertension
-hyperglycemia