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To prevent steroid-induced osteoporosis, the steroid dose and duration should be as low and as short as possible. All patients on long term glucocorticoids (≥3 months) should be encouraged to do weightbearing exercise, avoid smoking and excess alcohol and take fall prevention measures. Daily calcium and vitamin d intake should be sufficient.
once daily in the morning q.d.p.m. quaque die post meridiem: once daily in the evening q.d.s. quater die sumendus: 4 times a day can be mistaken for "qd" (every day) q.p.m. quaque die post meridiem: every evening (every day after noon) q.h. quaque hora: every hour q.h.s. quaque hora somni: every night at bedtime
every day / daily quaque die q.h.s., qhs every night at bedtime quaque hora somni q.d.s, qds, QDS 4 times a day quater die sumendum q.i.d, qid 4 times a day quater in die q.h., qh every hour, hourly quaque hora q.o.d., qod every other day / alternate days quaque altera die q.p.m., qPM, qpm every afternoon or evening: quaque post meridiem q.s., qs
Then change to oral hydrocortisone or cortisone as a single morning dose, and gradually decrease by 2.5 mg each week. When the morning dose is less than replacement, the return of normal basal adrenal function may be documented by checking 0800 cortisol levels prior to the morning dose; stop drugs when 0800 cortisol is 10 μg/dl.
Prednisone is a synthetic glucocorticoid used for its anti-inflammatory and immunosuppressive properties. [36] [37] Prednisone is a prodrug; it is metabolised in the liver by 11-β-HSD to prednisolone, the active drug. Prednisone has no substantial biological effects until converted via hepatic metabolism to prednisolone. [38]
For example, prednisone is used at low doses (equal to or less than 7.5 mg per day), medium doses (greater than 7.5 mg but less than 30 mg per day), or high doses (greater than 30 mg but less than 100 mg per day) to treat mild, moderate, or severe inflammations, respectively, such as those causing neurological, hematologic, and kidney disorders.
For calcium labeling purposes 100% of the Daily Value was 1000 mg, but in May 2016 it was revised to 1000–1300 mg. [50] A table of the pre-change adult Daily Values and references for the revision are provided at Reference Daily Intake. Food and supplement companies had until July 2018 to comply with the labeling change.
The neuropsychiatric effects are partly mediated by sensitization of the body to the actions of adrenaline. Therapeutically, the bulk of corticosteroid dose is given in the morning to mimic the body's diurnal rhythm; if given at night, the feeling of being energized will interfere with sleep. An extensive review is provided by Flores and Gumina ...
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