Tapering inhaled steroids

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

I find that the fatigue hits almost immediately after the attack, while the depression and despair hit during the attack.
In the ER today, I could feel the despair/ helplessness/hopelessness hit like a wave, and had to fight mentally to overcome it and stay calm. My attack took place out of town, and I had to walk 15 minutes to the ER, as I couldn’t talk on the phone (in my hand!!) nor would anyone respond to my attempts to flag down help. I truly didn’t think I would make it–inhaler didn’t even make a dent.

Variability in cortisol assays creates an additional problem with setting criteria for a normal response to ACTH that apply to all centers. Two studies comparing cortisol results obtained with different assays showed a positive bias of radioimmunoassays and immunofluorometric enzyme assays of 10 to 50 percent compared with a reference value obtained using isotope dilution gas chromatography-mass spectrometry. As a result, in one study, depending on the combination of assay and criterion used, between 0 and 100 percent of healthy volunteers would be considered to have a normal response to ACTH. This illustrates the difficulty of interpreting cortisol responses that are close to the cutoff point. (3)

During minor illness (., flu or fever >38° C [° F]) the hydrocortisone dose should be doubled for 2 or 3 days. The inability to ingest hydrocortisone tablets warrants parenteral administration. Most patients can be educated to self administer hydrocortisone, 100 mg IM, and reduce the risk of an emergency room visit. Hydrocortisone, 75 mg/day, provides adequate glucocorticoid coverage for outpatient surgery. Parenteral hydrocortisone, 150 to 200 mg/day (in three or four divided doses), is needed for major surgery, with a rapid taper to normal replacement during the recovery. Patients taking more than 100 mg hydrocortisone/day do not need any additional mineralocorticoid replacement. All patients should wear some form of identification indicating their adrenal insufficiency status.

Tapering inhaled steroids

tapering inhaled steroids

During minor illness (., flu or fever >38° C [° F]) the hydrocortisone dose should be doubled for 2 or 3 days. The inability to ingest hydrocortisone tablets warrants parenteral administration. Most patients can be educated to self administer hydrocortisone, 100 mg IM, and reduce the risk of an emergency room visit. Hydrocortisone, 75 mg/day, provides adequate glucocorticoid coverage for outpatient surgery. Parenteral hydrocortisone, 150 to 200 mg/day (in three or four divided doses), is needed for major surgery, with a rapid taper to normal replacement during the recovery. Patients taking more than 100 mg hydrocortisone/day do not need any additional mineralocorticoid replacement. All patients should wear some form of identification indicating their adrenal insufficiency status.

Media:

tapering inhaled steroidstapering inhaled steroids