Pituitary-adrenal function following long-term steroid therapy

Corticosteroid Therapy in Severe Illness

“…[70][71][72][73][74] However, high-dose corticosteroid therapy and prolonged treatment do not invariably correlate with the degree and duration of hypothalamic-pituitary-adrenal suppression, 72,73,75,76 and the time to recovery after discontinuation of corticosteroid therapy is highly variable. It can be as short as two to five days 76 or as long as nine months to one year.…”

Increased Plasma ACTH-like Activity Following Methopyrapone Administration in the Dog

“…However, reports of attempts at documentation of increase in plasma ACTHlike activity have been conflicting. In man, Meakin et al (4), using the hypophysectomized dog as a bio-assay system, were able to demonstrate increased ACTH-like activity in only seven out of 17 human subjects after prolonged oral methopyrapone administration. Liddle etal.…”

“…Heretofore, however, acute changes in plasma ACTH-like activity with methopyrapone infusions have not been directly demonstrated in man or dog. 529 Moreover, the reports of human plasma ACTH assay following several days of oral administration of methopyrapone are conflicting (4)(5)(6). This study was designed to assess the ACTH-like activity of dog plasma obtained before and during acute intravenous methopyrapone administration.…”

The Patient, the Prescription, the Problem: Corticosteroid Therapy in Otolaryngology

“…If he has previously been on corticosteroid therapy, as a rule of thumb, say during the past 12 months, he must be given intrave¬ nous corticosteroids to assure adequacy of the titers which he requires; this is an im¬ portant distinction which requires more em¬ phasis than it has been accorded in the past. 27 Esophageal Caustic ß«rns.-r'·8·15·28·38·45·53 Recently, controlled animal experiments have demonstrated that methylprednisolone can prevent the formation of esophageal strictures following lye ingestion and that antibiotics given along with corticosteroids lessen the incidence of perforation. Since perforation of the esophagus after bougienage of a patient on steroid therapy who had swallowed lye, has been reported, it is rec¬ ommended that two to four weeks be al¬ lowed after steroid withdrawal, before the passage of sounds is attempted.…”