Adverse effects of systemic corticosteroids

Sometimes, putative medical adverse effects are regarded as controversial and generate heated discussions in society and lawsuits against drug manufacturers. One example is the recent controversy as to whether autism was linked to the MMR vaccine (or by thiomersal , a mercury -based preservative used in some vaccines ). No link has been found in several large studies, and despite removal of thimerosal from vaccines a decade ago the rate of autism has not decreased as would be expected if it had been the causative agent. [37] [38]

For additional guidance on the use of Preservation Conditions, consider seeking legal counsel or contact the ACHP. When a federal agency is considering use of a Preservation Condition, the relevant SHPO/THPO may also be a useful source of information on the preservation needs of the property at hand, and also various considerations relevant to the substantive terms of the draft Preservation Condition. The ACHP intends to supplement this guidance with case studies (Appendix II.) and regularly update this guidance as necessary. If you have any suggestions about this guidance, please contact the ACHP at  preservationconditionguidance@ . 

Effective options for stress ulcer prophylaxis include PPIs, H 2 antagonists, antacids, and sucralfate (Carafate). No medication has been shown to be superior to another. Although the optimal duration of prophylaxis is not known, most experts suggest continuing therapy while the patient is in the ICU, when bleeding risk is highest. However, many patients continue to receive prophylaxis inappropriately when they are transferred to general medical units and continue therapy after discharge without clear medical indications. 31 To minimize adverse outcomes, physicians should discontinue PPIs in patients when they are discharged from the ICU if there are no other indications for therapy.

6) http:/// pubmed/1366242
Ir J Med Sci. 1992 Dec;161(12):684-6. TSH as an index of L-thyroxine replacement and suppression therapy. Igoe D1, Duffy MJ, McKenna TJ.
When hypothalamic-pituitary function is normal, serum TSH levels measured by ultrasensitive assay yield bioassays of endogenous thyroid action and thus provide an ideal index of thyroid secretion and its relationship to fluctuating endogenous thyroid levels. It is theoretically possible that patients receiving exogenous L-thyroxine for primary hypothyroidism should have suppressed TSH levels if physiological needs are constantly met . To examine this possibility free thyroxine, FT4 and TSH were measured in 90 clinically euthyroid patients receiving treatment with L-thyroxine for primary hypothyroidism. TSH levels were normal in 44, suppressed in 16 and elevated in 30 patients. FT4 levels were normal in 68, elevated in 13 and suppressed in 9 patients. Normal TSH levels were associated with normal FT4 levels in % of patients, elevated FT4 levels in % and low FT4 in %. Suppressed TSH levels were associated with elevated FT4 levels in % of patients and normal FT4 levels in %. When FT4 levels were normal, however, TSH levels were normal in only % and abnormal in %. We also examined the possibility that FT4 levels may remain within normal range when TSH is suppressed during L-thyroxine treatment for goitre or cancer. FT4 and TSH were measured in 45 patients on L-thyroxine as TSH suppression treatment. TSH was suppressed in 23 patients (%), normal in 20 (%) and elevated in 2 (%). When TSH was suppressed, FT4 was elevated in % but normal in % of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adverse effects of systemic corticosteroids

adverse effects of systemic corticosteroids

6) http:/// pubmed/1366242
Ir J Med Sci. 1992 Dec;161(12):684-6. TSH as an index of L-thyroxine replacement and suppression therapy. Igoe D1, Duffy MJ, McKenna TJ.
When hypothalamic-pituitary function is normal, serum TSH levels measured by ultrasensitive assay yield bioassays of endogenous thyroid action and thus provide an ideal index of thyroid secretion and its relationship to fluctuating endogenous thyroid levels. It is theoretically possible that patients receiving exogenous L-thyroxine for primary hypothyroidism should have suppressed TSH levels if physiological needs are constantly met . To examine this possibility free thyroxine, FT4 and TSH were measured in 90 clinically euthyroid patients receiving treatment with L-thyroxine for primary hypothyroidism. TSH levels were normal in 44, suppressed in 16 and elevated in 30 patients. FT4 levels were normal in 68, elevated in 13 and suppressed in 9 patients. Normal TSH levels were associated with normal FT4 levels in % of patients, elevated FT4 levels in % and low FT4 in %. Suppressed TSH levels were associated with elevated FT4 levels in % of patients and normal FT4 levels in %. When FT4 levels were normal, however, TSH levels were normal in only % and abnormal in %. We also examined the possibility that FT4 levels may remain within normal range when TSH is suppressed during L-thyroxine treatment for goitre or cancer. FT4 and TSH were measured in 45 patients on L-thyroxine as TSH suppression treatment. TSH was suppressed in 23 patients (%), normal in 20 (%) and elevated in 2 (%). When TSH was suppressed, FT4 was elevated in % but normal in % of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

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