Steroid refractory disease definition

Several brands of IVIG have been approved by the Food and Drug Adminsitration (FDA) (see table in Appendix).  There is a lack of reliable evidence that any one brand of IVIG is more effective than other brands.  However, immune globulin products may differ from each other in ways that may be important in a particular patient.  Different manufacturers then use various combinations of precipitation and/or chromatography steps to obtain a final preparation that consists of greater than 95 % IgG in all currently available products.  The various manufacturers also use different final purification steps and stabilizers to obtain their final products, which may then vary in storage requirement and shelf life.  In several currently available products, stabilizers include sugars, such as sucrose, glucose, or maltose.  Other products contain amino acids such as glycine and proline.  The sodium content of different products also varies.

Benzodiazepines may influence neurosteroid metabolism by virtue of their actions on translocator protein (TSPO; "peripheral benzodiazepine receptor"). [59] The pharmacological actions of benzodiazepines at the GABA A receptor are similar to those of neurosteroids . Factors which affect the ability of individual benzodiazepines to alter neurosteroid levels may depend upon whether the individual benzodiazepine drug interacts with TSPO. Some benzodiazepines may also inhibit neurosteroidogenic enzymes reducing neurosteroid synthesis. [60]

Webster and Walker (2006) examined the safety and effectiveness of prolonged low-dose, continuous intravenous (IV) or subcutaneous ketamine infusions in non-cancer outpatients.  A total of 13 outpatients with neuropathic pain were administered low-dose IV or subcutaneous ketamine infusions for up to 8 weeks under close supervision by home health care personnel.  Using the 10-point VAS, 11 of 13 patients (85 %) reported a decrease in pain from the start of infusion treatment to the end.  Side effects were minimal and not severe enough to deter treatment.  Prolonged analgesic doses of ketamine infusions were safe for the small sample studied.  The authors concluded that these findings demonstrate that ketamine may provide a reasonable alternative treatment for non-responsive neuropathic pain in ambulatory outpatients.  Moreover, the authors stated that additional studies should follow to ascertain optimal dose and duration for specific pain disorders and to minimize side effects.  They also noted that questions regarding which patients would be most susceptible to this type of therapy and when treatment should be instituted remain unanswered. 

Steroid-induced osteoporosis (SIOP) is osteoporosis arising due to use of glucocorticoids (steroid hormones) - analogous to Cushing's syndrome and involving mainly the axial skeleton. The synthetic glucocorticoid prescription drug prednisone is a main candidate after prolonged intake. Bisphosphonates are beneficial in reducing the risk of vertebral fractures. [1] Some professional guidelines recommend prophylactic calcium and vitamin D supplementation in patients who take the equivalent of more than 30 mg hydrocortisone ( mg of prednisolone), especially when this is in excess of three months. [2] [3] The use of thiazide diuretics, and gonadal hormone replacement has also been recommended, with the use of calcitonin, bisphosphonates, sodium fluoride or anabolic steroids also suggested in refractory cases. [4] Alternate day use may not prevent this complication. [5]

Steroid refractory disease definition

steroid refractory disease definition

Steroid-induced osteoporosis (SIOP) is osteoporosis arising due to use of glucocorticoids (steroid hormones) - analogous to Cushing's syndrome and involving mainly the axial skeleton. The synthetic glucocorticoid prescription drug prednisone is a main candidate after prolonged intake. Bisphosphonates are beneficial in reducing the risk of vertebral fractures. [1] Some professional guidelines recommend prophylactic calcium and vitamin D supplementation in patients who take the equivalent of more than 30 mg hydrocortisone ( mg of prednisolone), especially when this is in excess of three months. [2] [3] The use of thiazide diuretics, and gonadal hormone replacement has also been recommended, with the use of calcitonin, bisphosphonates, sodium fluoride or anabolic steroids also suggested in refractory cases. [4] Alternate day use may not prevent this complication. [5]

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