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Continuing the maintenance dose for about 4 to 5 half-lives (t 1/2) of the drug will approximate the steady state level. [1] One or more doses higher than the maintenance dose can be given together at the beginning of therapy with a loading dose. [2] A loading dose is most useful for drugs that are eliminated from the body relatively slowly ...
dextrose 5% in normal saline (0.9%) (intravenous sugar solution) D5W, D 5 W dextrose 5% in water (intravenous sugar solution) D10W, D 10 W dextrose 10% in water (intravenous sugar solution) da da: give DAW dispense as written (i.e., no generic substitution) DC, dc, D/C, disc discontinue [or] discharge ambiguous meaning decoct.
Prednisone is the drug of choice for PMR, [19] and treatment duration is frequently greater than one year. [15] If the patient does not experience dramatic improvement after three days of 10–20 mg oral prednisone per day, the diagnosis should be reconsidered. [20] Sometimes relief of symptoms occurs in only several hours. [19]
Once remission is induced, maintenance levels can be used: sulfasalazine 2 g/day, mesalamine 1.2-2.4 g/day, or olsalazine 1 g/day. Patients on high dose sulfasalazine require folic supplementation (1 mg/day) because it inhibits folate absorption. If oral Mesalazine is still not working, prednisone is often given, starting at 40–60 mg/day.
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]
Methylprednisolone dose and duration have been implicated in PAE development. 20 mg/day of prednisone (16 mg/day of methylprednisolone) is the threshold dosage for PAE development agreed upon by many studies. [24]
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25 mg of hydrocortisone every eight hours for 24 hours. Resume usual dose thereafter. Major surgical stress (eg, esophagogastrectomy, total proctocolectomy, open heart surgery) 100 mg hydrocortisone IV: 50 mg every eight hours for 24 hours. Taper dose by half per day to maintenance level.