Jaward Leanna R, O'Neil Thomas A, Marks Adam, Smith Michael A
1 Pharmacy Resident, Beaumont Hospital, Troy, MI, USA.
2 Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Am J Hosp Palliat Care. 2019 Feb;36(2):158-168. doi: 10.1177/1049909118797283. Epub 2018 Aug 30.
: Corticosteroids are frequently utilized in the palliative care setting to combat symptoms such as fatigue, dyspnea, pain, weakness, anorexia, cachexia, nausea, and vomiting. Often times, adverse effects arise with corticosteroid use, and it is unclear whether switching to another corticosteroid would reduce the risk of specific adverse effects or what measures can be taken to alleviate the adverse effects.
: This article aims to review the differentiating pharmacokinetics, potency, and adverse effect profiles of corticosteroids and summarize their clinical applicability.
: A literature review of "corticosteroids" and "palliative care" was performed using the PubMed database through July 2018. Original studies relevant to the purpose of this study were identified and those that met inclusion criteria were included.
: Although corticosteroids share many common factors, including similar pharmacokinetic, pharmacodymanic, and adverse effect profiles, they have significant differences when the details of these variables are reviewed. Providers that prescribe corticosteroids for symptom management should be aware of these differences and the recommended management strategies.
: Recognition of corticosteroid induced adverse effect profiles and possible management strategies is crucial to optimal symptom management in palliative care patients.
在姑息治疗中,皮质类固醇常用于对抗疲劳、呼吸困难、疼痛、虚弱、厌食、恶病质、恶心和呕吐等症状。皮质类固醇的使用常常会产生不良反应,目前尚不清楚换用另一种皮质类固醇是否会降低特定不良反应的风险,或者可以采取哪些措施来减轻这些不良反应。
本文旨在综述皮质类固醇在药代动力学、效力和不良反应方面的差异,并总结其临床适用性。
通过PubMed数据库对截至2018年7月的“皮质类固醇”和“姑息治疗”进行文献综述。确定与本研究目的相关的原始研究,并纳入符合纳入标准的研究。
尽管皮质类固醇有许多共同因素,包括相似的药代动力学、药效学和不良反应特征,但当对这些变量的细节进行审查时,它们存在显著差异。为症状管理开具皮质类固醇的医疗人员应了解这些差异及推荐的管理策略。
认识皮质类固醇引起的不良反应特征和可能的管理策略对于姑息治疗患者的最佳症状管理至关重要。