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Prednisone may start to result in the suppression of the hypothalamic–pituitary–adrenal (HPA) axis if used at doses 7–10 mg or higher for several weeks. This is approximately equal to the amount of endogenous cortisol produced by the body every 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 often takes effect within 10–14 days. The dose should then be tapered by about 5 mg/week until it can be stopped altogether.
In a prospective study, the cumulative incidence of CIL with high-dose prednisone therapy was found to be 61% after 3 months, 65% after 6 months, 68% after 9 months, and 69% after 12 months. [1] One study found that even a very low dosage of prednisone of 5 mg/day was associated with symptoms of "Cushing's syndrome". [1]
Methylprednisolone (Depo-Medrol, Medrol, Solu-Medrol) is a synthetic glucocorticoid, primarily prescribed for its anti-inflammatory and immunosuppressive effects. [4] [5] [6] It is either used at low doses for chronic illnesses or used concomitantly at high doses during acute flares.
every morning (every day before noon) q.d./q.1.d. quaque die: every day mistaken for "QOD" or "qds," AMA style avoids use of this abbreviation (spell out "every day") q.d.a.m. quaque die ante meridiem: 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
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Large dosage variations in the patient's medication (including a self-increased dosage from 10 mg/day to as much as 100 mg/day for at least 3 months) produced extreme behavioral changes, from missed appointments to physical altercations, and eventually admission to a psychiatric ward and later to a locked Alzheimer facility.
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