A clinic patient who has been taking a glucocorticoid for arthritis for several months remarks to the nurse, "It's a good thing my symptoms are better, because my mother has been quite ill, and I have to take care of her."
The patient's blood pressure is 100/60 mm Hg. The nurse will report this to the provider and ask about:
a. reducing the patient's dose.
b. using every other day dosing.
c. increasing the patient's dose.
d. tapering the dose.
ANS: C
Because of their adrenal suppression, patients taking glucocorticoids long term require increased doses at times of stress and even for a time after stopping the drug until adrenal function returns. This patient's lower blood pressure is an indication that glucocorticoid levels may be depleted. Reducing the dose would only exacerbate the patient's problems. Every other day dosing is used early in glucocorticoid therapy to reduce adrenal suppression, but it would not be useful now. Tapering of doses is used to allow adrenal function to recover as the drug is discontinued.
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