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Therefore, it is important to slowly reduce the dosage of steroids to allow the adrenal glands to gradually regain their ability to produce cortisone on their own. References (1) Karpin I, Reinehr MA, Kortemme F, Meeuwenberg C, Schulz S, tablets cortisone dosage. Adrenocortical dysregulation in athletes with long term corticosteroids, in: Aragon AA, Breen L, tablets cortisone dosage. Toxicon, tablets cortisone dosage. 2005 Jul/Aug/Mar;6(7):719-31, cortisone tablets dosage.
Steroid induced IOP elevation almost never occurs within the first two weeks of steroid use, and if it happens it will occur any time between 3 weeks and years, with the last peak occurring just under 6 years later (Figure). In patients who are predisposed to IOP elevation (e.g. hypertension) or who are currently on or have been on a low dose steroid, the peak IOP elevation is often not seen until around 12 weeks of use, but more commonly occurs between 20 and 30 weeks (Figure). Symptoms The symptoms of an increase in IOP occur in 3 phases (Figure): Progressive IOP rises as the result of the increasing steroid dosage, even during an initial plateau stage. (This is known as the initial plateau phase). Progression IOP rises as the result of the increase in dose. (At higher doses the levels continue to grow over time, with the first peak occurring approximately 3 months into the dose, during which peak the peak intensity can range from a small increase of 0.5-1.0 mmol/l to a large increase of 1.4-2.2 mmol/l). If the peak IOP elevation is too high, the patient becomes hypovolemic, and may have the signs of ventricular arrhythmias which may produce chest pain, a runny nose, tingling sensation (known as myocardial ischaemia) and/or a palpitation (Figure). Although these symptoms may feel like IOP elevation, are common as a result of increasing levels, and have been found to occur in most of the patients in my clinic, most patients will never find themselves at risk for ventricular arrhythmias or a heart attack. What to do when you see IOP elevation in your patients The first thing you should do is to advise patients that they are at risk and make the necessary adjustment. The first thing you should do is to advise patients that they are at risk and make the necessary adjustment. If the patient wants to start on a different dose than normal that is fine, as long as they do the following: Change a non-working systolic blood pressure scale; Change a non-working diastolic blood pressure scale; Change a baseline value from their primary care doctor; and Change a baseline value from their primary care doctor; and Monitor their other vital signs carefully. This will give you all an idea of any potential increase that might be occurring, as well as allow you to make appropriate adjustments before the start of the dose. Also, for patients Related Article:
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