Topics Discussed: endocrinology; glucocorticoids; pediatric endocrinology.
Sections: Replacement Therapy, Commonly Used Glucocorticoid Preparations, Withdrawal of Glucocorticoid Therapy, Mineralocorticoid Replacement, References.
Excerpt:"Glucocorticoids are used in adrenal replacement therapy when
adrenal insufficiency occurs, or as pharmacologic agents. Following
withdrawal of glucocorticoids used for pharmacologic therapy adrenal
insufficiency can persist for months, especially during times of
stress. The only differences among the various glucocorticoids are their
ratio of glucocorticoid to mineralocorticoid activity, their capacity
to bind to various binding proteins, their molar potency, and their
biologic half life. Dexamethasone is commonly used in reducing
increased intracranial pressure and brain edema. Neurosurgical experience
indicates that the optimal doses are 10 to 100 times those that
would thoroughly saturate all available glucocorticoid receptors,
suggesting that this action of dexamethasone may not be mediated
through the glucocorticoid receptor...."
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