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[Visitor (58.214.*.*)]answers [Chinese ]Time :2020-10-14
⑴Medication during pregnancy; glucocorticoids can pass through the placenta. Animal experiments have confirmed that administration during pregnancy can increase the incidence of embryonic jaw cracks, placental insufficiency, spontaneous abortion and intrauterine growth retardation. Human use of pharmacological doses of glucocorticoids It can increase the incidence of placental insufficiency, neonatal weight loss or stillbirth. It has not been proven to have teratogenic effects in humans. Those who have received a certain dose of glucocorticoid during pregnancy should pay attention to whether the adrenal cortex function is reduced. which performed.For premature infants, in order to avoid respiratory distress syndrome, dexamethasone is given to the mother before delivery to induce the formation of pulmonary surfactant protein in premature infants. Because it is only used for a short period of time, it has no adverse effects on the growth and development of infants...
⑵ Medication during lactation: physiological dose or low pharmacological dose (cortisone 25mg per day or prednisone 5mg, or less) generally has no adverse effects on infants. However, if lactating mothers receive large doses of pharmacological glucocorticoids, they should not breast-feed, because glucocorticoids can be excreted in the milk, causing adverse effects on the baby, such as growth inhibition and adrenal cortex function inhibition.
⑶ Pediatric medication: If children use adrenal cortex hormones for a long time, they need to be very cautious, because hormones can inhibit the growth and development of children. If long-term use is really necessary, short-acting (such as cortisone) or medium-acting preparations (such as Prednisone), avoid the use of long-acting preparations (such as dexamethasone). Oral intermediate-acting preparations can reduce the growth inhibition effect on alternate days. Long-term use of glucocorticoids in children or adolescents must be closely observed. Osteoporosis occurs in children The risk of disease, avascular necrosis of the femoral head, glaucoma, and cataracts all increase. In addition to the general age or weight of children, the dose of hormones used by children should be determined by the severity of the disease and the response of the child to treatment..For the treatment of children with adrenal hypofunction, the amount of hormones should be based on body surface area. If it is based on body weight, overdose is likely to occur, especially in infants and children with short or obese...
⑷Medication for the elderly: Elderly patients are prone to hypertension with glucocorticoids. Elderly patients, especially women after menopause, are prone to osteoporosis using glucocorticoids.
⑸Glucocorticoids and infection: patients with hypoadrenal function are prone to infection, and how serious is it, which is an important cause of death. Physiological doses of adrenal corticosteroids can improve the patient's resistance to infection. Non-adrenal hypofunction patients accept After pharmacological doses of glucocorticoids are prone to infection, this is because the patient’s original disease has often weakened the cellular immunity and/or humoral immune function, and the long-term over-physiological dose of corticosteroids causes the patient’s inflammatory response, cellular immunity, and humoral Immune function is weakened, and pathogenic bacteria that invade from the skin, mucous membranes and other parts cannot be controlled. Under the action of hormones, the originally controlled infection can be activated, and the most common case is recurrence of tuberculosis infection.After infection, patients receiving glucocorticoids are prone to missed diagnosis due to mild inflammatory reactions and unobvious clinical symptoms. The above shows that non-physiological glucocorticoids are not good for fighting infections. On the other hand, the use of hormones in certain infections can be Reduce tissue damage, reduce exudation, and reduce symptoms of infection and poisoning, but must be treated with effective antibiotics at the same time, and the changes in the condition must be closely observed. After short-term medication, the dose should be reduced and the drug should be stopped quickly...
⑹The following conditions should be used with caution; heart disease or acute heart failure, diabetes, diverticulitis, emotional instability and mental illness, systemic fungal infection, glaucoma, liver damage, ocular herpes simplex, hyperlipoproteinemia, high Blood pressure, hypothyroidism (the effect of corticosteroids is enhanced at this time), myasthenia gravis, osteoporosis, gastric ulcer, gastritis or esophagitis, renal damage or stones, tuberculosis, etc.
⑺ Glucocorticoids should not be used in the following situations: severe psychiatric history, active gastric and duodenal ulcers, recent gastrointestinal anastomosis, severe osteoporosis, obvious diabetes, severe hypertension, failure to use Virus, bacteria, and mold infections controlled by antibacterial drugs. Adrenal hyperfunction, hypertension, atherosclerosis, heart failure, diabetes, psychosis, epilepsy, postoperative, stomach, duodenal and corneal ulcers, intestinal diseases, chronic malnutrition should be avoided. Prohibited by pregnant women. Use with caution for viral infections.
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