A client who has been taking 80 mg of prednisone, a glucocorticoid, each day has been warned by his primary care provider to carefully follow a plan for the gradual reduction of the dose rather than stopping the drug suddenly
What is the rationale for this directive?
A) Sudden changes in glucocorticoid dosing may reverse the therapeutic effects of the drug.
B) Stopping the drug suddenly may "shock" the HPA axis into overactivity.
C) Sudden cessation of a glucocorticoid can result in adrenal gland necrosis.
D) Stopping the drug suddenly may cause acute adrenal insufficiency.
Ans: D
Feedback:
Chronic suppression of the HPA system by the use of steroids causes atrophy of the adrenal gland, and the abrupt withdrawal of drugs can cause acute adrenal insufficiency. Activity of the HPA system is consequently insufficient. The efficacy of the drug is not the primary concern, and necrosis of the gland itself does not occur.
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