Glukokortikoid Kullanan Hastanın Yönetimi

Günümüzde glukokortikoidler çok sayıda otoimmun ve inflamatuar hastalıkların tedavisindeyaygın olarak kullanılmaktadır. Adrenal yetmezlik tedavisinde tedavi dozu fizyolojikolmakla birlikte bazı romatolojik, oftalmolojik, hematolojik, pulmoner ve gastrointestinalsistem hastalıklarında suprafizyolojik dozlarda kullanılmaktadır. Yararlı etkilerininyanı sıra oral veya parenteral uzun süreli sistemik glukokortikoid kullanımı baştaosteoporoz ve kırıklar, adrenal baskılanma, kan şekeri regulasyonunun bozulması, kiloalımı, kardiyovasküler hastalık, dislipidemi, psikiyatrik bozukluklar, gastrointestinal sistemşikayetleri olmak üzere pek çok yan etki yapabilir. Yan etkiler arasında hiperglisemi,hiperlipidemi, peptik ülser ve psikolojik değişiklikler daha çok doz bağımlı iken, osteoporoz,cushingoid görünüm, kan basıncı yüksekliği, fırsatçı enfeksiyonlar daha çokkullanım süresi ile ilişkilidir. Bu yan etkilerin çoğu hastaların dikkatli ve yakın izlemi,altta yatan hastalığı kontrol edecek en düşük dozun kullanılması gibi koruyucu önlemlerinalınması ile azaltılabilir.

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