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High-dose estrogen therapy (HDE) is a type of hormone therapy in which high doses of estrogens are given. [1] When given in combination with a high dose of progestogen , it has been referred to as pseudopregnancy .
[1] [4] Corticosteroid treatment has also been suggested as an early treatment option in patient with acute respiratory distress syndrome. Steroids have not been shown beneficial for sepsis alone. [22] Historically, higher doses of steroids were given, but these have been suggested to be harmful compared to the lower doses which are advocated ...
Antenatal steroids have also been shown to have definite beneficial effect in treating the condition of preterm premature rupture of membranes (PPROM). [8] Similar to its effects on preterm birth, research evidence suggests that the administration of antenatal steroids to patients with PPROM reduces risks of neonatal mortality, intraventricular hemorrhage and respiratory distress syndrome.
If high doses were used for six to 10 days, reduce to replacement dose immediately and taper over four more days. Adrenal recovery can be assumed to occur within two to four weeks of completion of steroids. If high doses were used for 11–30 days, cut immediately to twice replacement, and then by 25% every four days.
Research on animal reproduction has indicated that there is a trace of teratogenicity when doses are reduced by 10 times the human recommended dose. [54] There is no sufficient information on human pregnancy at this moment. Use is only recommended when the potential benefits outweigh the potential risks for the pregnant mother and the fetus. [54]
Micrograph of fatty liver, as may be seen due to long-term prednisone use. Trichrome stain.. Short-term side effects, as with all glucocorticoids, include high blood glucose levels (especially in patients with diabetes mellitus or on other medications that increase blood glucose, such as tacrolimus) and mineralocorticoid effects such as fluid retention. [24]
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.
Perioperative stress dose of steroids to mitigate this rare but potentially fatal complications of perioperative use of steroid such as full-blown adrenal crisis in the perioperative period due to the secondary adrenal insufficiency. Various exogenous steroid preparations are used for a wide range of indications. [1]