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The term "steroid dementia" was coined by Varney et al. (1984) in reference to the effects of long-term glucocorticoid use in 1,500 patients. [3] While the condition generally falls under the classification of Cushing's syndrome , the term "steroid dementia syndrome" is particularly useful because it recognizes both the cause of the syndrome ...
The combination is then referred to as COP (cyclophosphamide, Oncovin, and prednisone or prednisolone) or CVP (cyclophosphamide, vincristine, and prednisone or prednisolone). As elderly patients have a greater risk of toxicity from the drugs, an option is to use an attenuated drug regimen, called miniCHOP.
This weaning process may be over a few days if the course of prednisone is short but may take weeks or months [33] if the patient had been on long-term treatment. Abrupt withdrawal may lead to an Addisonian crisis. For those on chronic therapy, alternate-day dosing may preserve adrenal function and thereby reduce side effects. [34]
During this recovery time, the patient is vulnerable to adrenal insufficiency during times of stress, such as illness. While suppressive dose and time for adrenal recovery vary widely, clinical guidelines have been devised to estimate potential adrenal suppression and recovery, to reduce risk to the patient. The following is one example:
[7] [8] [6] It differs from the similarly named prednisone in having a hydroxyl at the 11th carbon instead of a ketone. Common side effects with short-term use include nausea, difficulty concentrating, insomnia, increased appetite, and fatigue. [5] More severe side effects include psychiatric problems, which may occur in about 5% of people. [9]
Use of corticosteroids has numerous side-effects, some of which may be severe: Severe amoebic colitis: Fulminant amoebic colitis is associated with high case fatality and can occur in patients infected with the parasite Entamoeba histolytica after exposure to corticosteroid medications. [19]
Classically, for clinical indications of an approved drug, TI refers to the ratio of the dose of the drug that causes adverse effects at an incidence/severity not compatible with the targeted indication (e.g. toxic dose in 50% of subjects, TD 50) to the dose that leads to the desired pharmacological effect (e.g. efficacious dose in 50% of ...
Elderly people are also at a heightened risk for developing TD, [10] as are females and those with organic brain injuries or diabetes mellitus and those with the negative symptoms of schizophrenia. [25] TD is also more common in those that experience acute neurological side effects from antipsychotic drug treatment. [25]