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Pulmonary fibrosis in hormone use _85283


									?Pulmonary fibrosis in hormone use


Treatment of pulmonary fibrosis hormone which, how to apply? here's
treatment of pulmonary fibrosis of corticosteroid use knowledge:

Corticosteroids: corticosteroids is the traditional treatment for
pulmonary fibrosis mainly drug, clinical applications more is
prednisone. Corticosteroids can inhibit inflammation and immune
processes, reduce inflammation, thereby delaying the alveolar
fibrosis of the lung. For stages in Alveolitis patients significantly.
But the effects of significant pulmonary fibrosis in patients with
interstitial lung disease for many is mainly collagen vascular
diseases of pulmonary manifestations and pulmonary Vasculitis is the
main manifestation of Vasculitis. Moreover, the significant number of
patients is 50 years old. For is already in pulmonary fibrosis stage
of patients, glucocorticoid effects are not obvious. The general use
of oral prednisone. Shandong University affiliated hospital of
respiratory medicine Zhang Wei

(1) the indication: acute, chronic-type activities, chronic form of
acute deterioration of the case, bronchoalveolar lavage (BALF) to
check the number of neutrophils and eosinophils.

(2) treatment: early acute type advocated timely enough medication,
there is the possibility of cure or improvement; chronic type used in
the treatment of content and maintenance dose.

(3): acute, prednisolone 600mg/d, symptom control and stability,
improved Lung absorption may decrement the shadow. Every 2-4 weeks
minus 5 mg/d, when reduced to 30mg/d, each reduction shall be 2.
5mg/d, so as not to cause illness rebound. Maintenance dose not less
than the amount 10mg/d, more vulnerable to recurrent and long-term
medication. When the illness for most acute progress, or when you
check BALF neutrophils obviously increase, eosinophils, available
pulse therapy, methylprednisolone 500 ~ 1000mg/d, with 3 to 5 days
after gradual reduction or use prednisone. ‫ڠ‬chronic type,
methylprednisolone normal dose 30mg/d, symptom control, progressive
reductions after about 8 weeks after reduction of 5 mg/d, maintain 4-
8 weeks to 20mg/d is reduced each time only 2.5mg/d. Maintenance dose
not less than 10mg/d. According to experience sustained capacity in 5
~ 7.5mg/d is prone to recur. Effects of unsatisfactory on hormones
may be combined with immunosuppressive agents.

However, long-term hormone can cause a series of reactions, hormone
side effects including the following:
1. metabolism and water-salt metabolism disorder
Excessive application of corticosteroids can cause metabolism and
water-salt metabolism disorder, a class of Adrenocortical
Hyperfunction syndrome, such as edema, hypokalemia, hypertension,
diabetes, skin becomes thin, full moon face, Buffalo back, polulation,
hairy, acne, muscle weakness and muscular atrophy, and other symptoms
generally do not need special treatment, after may subside. But with
myasthenia gravis recovery slow and incomplete. Low-salt, low-sugar,
high-protein diet and combined with potassium chloride and other
measures to reduce these symptoms. In addition, glucocorticoid
inhibition of protein synthesis due to delayed wound healing of
trauma patients. In children may inhibit the secretion of growth
hormone and caused negative nitrogen balance growth affected.
2. induced or aggravate infections
Corticosteroids can inhibit the body's immune function, and no
antibacterial effect, so long-term application can often increase
infection caused by infection or, you can make the body a potential
infection lesions spread or still infected stove comes alive,
especially the original resistance decrease, such as nephrotic
syndrome, pulmonary tuberculosis, aplastic anemia patients. Due to
the use of glucocorticoids, patients often feel good, covers the
development of symptoms of infection, decided to adopt long-term
therapy should be checked before the body, eliminating a potential
infection, the application process should be vigilant, if necessary
in combination with effective antibiotics, paying particular
attention to prevention and treatment of latent tuberculosis lesions.
3. gastrointestinal complications
Gucocorticoid can stimulate the secretion of gastric acid, pepsin and
inhibit the secretion of gastric mucus, reduce gastric mucosal
resistance, it can trigger or aggravate peptic ulcer, corticosteroids
can covered up ulcer symptoms at the initial stage, resulting in a
sudden hemorrhage and severe complications such as perforation, it
should be noted. Long-term use could enable the gastric or duodenal
ulcer exacerbation. In combination with other gastric stimulation
drugs (e.g. aspirin, indometacin, butazolidin) are more prone to this
side effect. On a small number of patients may induce pancreatitis or
fatty liver.
4. cardiovascular complications
Long-term use of corticosteroids, can cause water retention and
sodium, cholesterol, can be induced atherosclerosis and hypertension.
5. osteoporosis and vertebral compression fracture
Osteoporosis and vertebral compression fracture is all ages with
glucocorticoid therapy in severe complications. Ribs and spine high
beam, usually the most affected. This may with glucocorticoid
inhibition of Osteoblast activity, increase the excretion of calcium
and phosphorus, inhibits intestinal calcium absorption and bone cells
to the sensitivity of parathyroid and other factors. In the event of
osteoporosis drug must be stopped. For the prevention and treatment
of osteoporosis should vitamin D (vitamin D), the assimilation of
calcium and protein hormone, etc.
6. neuropsychological abnormalities
Corticosteroids can cause unexpected behavior in a variety of forms.
As euphoric phenomenon can often mask the symptoms of some diseases
and relying on a diagnosis. Again such as nervousness, agitation,
insomnia, emotional change or even obvious symptoms of mental illness.
Some patients also have suicidal tendencies. In addition,
corticosteroids may induce seizures.
7. the cataract and glaucoma

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