What should children be aware of when using glucocorticoids?

When a child has nephrotic syndrome, corticosteroids are the best way to do it. However, there are many contraindications to this drug, and if used incorrectly, the situation can be worsened. Today we are going to talk about what things should be paid attention to?

First, caution should be exercised in patients with Cushing's syndrome, atherosclerosis, intestinal disease, or chronic malnutrition, as well as in patients after recent surgery. Acute heart failure, diabetes, psychotic tendency, glaucoma, hyperlipoproteinemia, hypertension, myasthenia gravis, severe osteoporosis, peptic ulcer disease should be used with caution, infectious diseases must be combined with effective antibiotics, and patients with viral ** infection should be used with caution.

To prevent cross-allergies, people who are allergic to one glucocorticoid drug may also be allergic to other glucocorticoids. When glucocorticoids are used, a diet low in sodium, high in potassium, and high in protein should be used; Calcium and vitamin D supplementation; add drugs to prevent adverse reactions such as peptic ulcer and bleeding; In the case of infection, antibiotics should be used at the same time to prevent the spread and worsening of the infection.

Attention should be paid to the reasonable selection of glucocorticoid varieties and dosage forms according to the pharmacokinetic characteristics of different glucocorticoids and the specific conditions of the disease. Interactions between glucocorticoids and other drugs should also be noted: recent use of barbiturates, carbamazepine, phenytoin, pamidone, or rifampicin may enhance metabolism and decrease the effects of systemic glucocorticoids.

Conversely, oral contraceptives or ritonavir can increase blood levels of corticosteroids.

This drug is dangerous and is a prescription drug, so be sure to take it in accordance with the dosage under the guidance of a doctor. Do not buy on your own or increase or decrease the dose without authorization.

Be sure to pay attention to the concentration not too high each time, and it must be diluted to a certain extent.

When using glucocorticoids, cross-infection should be prevented, and some vitamins and calcium should be supplemented promptly after use.

Children must be very careful when using this glucocorticoid to avoid cross-infection.

It should be diluted, otherwise children may not be able to stand it, and the concentration is too high.

There are many things that should be paid attention to, such as whether it is allergic or not.

Gargling with water immediately after inhalation can reduce or avoid local adverse reactions.

There are many contraindications for this, such as not being able to use it after surgery.

Care should be taken when using this medication with some vitamin D.

It is important to see if the child is allergic to these things.

Answer]: a, b, c, d, e

Frequency of use: Usually twice a day. Studies have shown that the frequency of using it three times a day or more does not increase the effect of hormones, but will lead to a higher probability of its occurrence; Woodman parts used:

For the face, folds and other parts, weak hormones should be used; The rest of the parts can be selected with appropriate hormone preparations according to the condition; When you use it, you orange and fierce man: allergic diseases are generally used for about 5 days; Immune diseases are used for a longer period of time. For example, in psoriasis**, the maximum single course of hormones used in the same area is 4 weeks, followed by 2 weeks of moisturizers as intervals; Hormone dosage:

It should be appropriate, and too much and too little is not appropriate for the patient's disease control.

Answer]: dexamethasone, also known as flumethasone, flumetholone, and desalmetsone, is a glucocorticoid hormone. Its derivatives include hydrocortisone, prednisone, etc., and its pharmaco-venetian effects are mainly anti-inflammatory, anti-toxic, anti-allergic, anti-rheumatism, and are widely used in clinical practice.

It is easily absorbed from the digestive tract, and its plasma T1 2 is 190 minutes, tissue T1 2 is 3 days, and the peak blood concentration is reached at L hour and 8 hours after intramuscular injection of dexamethasone sodium phosphate or dexamethasone acetate, respectively. The plasma protein binding rate of this product is lower than that of other corticosteroid drugs. The anti-inflammatory activity of this product is equivalent to 5mg of prednisolone.

Adrenocorticosteroids have stronger anti-inflammatory, anti-allergic and antitoxic effects than prednisone, sodium and water retention and potassium excretion are very light, and intramuscular injection or intravenous drip has a strong effect on pituitary-adrenal gland suppression.

Answer]: A glucosteroids are mainly used in adrenal insufficiency, severe infectious inflammation, autoimmune and allergic diseases, respiratory diseases, blood diseases such as thrombocytopenia, ** diseases, inflammatory eye diseases, etc., so options B, C, D, and E are all indications for glucocorticoids, but option A chickenpox mostly occurs in children, and the use of glucocorticoids in children is easy to cause growth retardation and cause virus spread, so it should be used with caution. So choose A.

Answer]: A This question briefly examines the clinical application of glucocorticoids. Glucocorticoids can be used in various shocks, and the rest of the answers are contraindications. Therefore, the answer is A.

Long-term or high-dose use of glucocorticoids can be caused.

a.Decreased secretion of gastric acid.

b.Blood sugar is lowered.

c.Promotes bone development.

d.Central obesity.

e.Prevents the formation of peptic ulcer leakage.

Correct answer: d

Absolute contraindications to glucocorticoid use are: History of severe psychiatric illness; overt diabetes mellitus; Osteoporosis; Zen foci in the first trimester of pregnancy; severe hypertension; Uncontrolled He Shenyi is seriously infected; Glaucoma; severe hypokalemia; Cortisol blind hyperasia.

1. Adverse reactions caused by long-term large-scale application.

1) Hypercortical syndrome. Full moon face, buffalo back, high blood pressure, hirsutism, diabetes, **thinning, etc. It is caused by GCS and metabolic disorders.

2) Induce or aggravate infection. The main reason is that hormones reduce the body's resistance to pathogenic microorganisms.

3) Induce or aggravate ulcer disease.

4) Induce hypertension and arteriosclerosis.

5) Osteoporosis, muscle atrophy, and delayed wound healing.

6) Induce psychosis and epilepsy.

7) Inhibition of children's growth and development.

8) Others: negative nitrogen balance, increased appetite, hypocalcemia, hyperglycemic tendency, peptic ulcer, euphoria.

9) Necrosis of the femoral head (in SARS**, 300 patients registered in Beijing were incapacitated due to the large use of glucocorticoids in SARS**).

2. Discontinuation reaction.

1) Adrenal cortex atrophy or insufficiency. Long-term users can reduce the dose too quickly or stop the drug abruptly, which can cause adrenal insufficiency. When GCS is used for a long time, it can cause cortical atrophy.

After abrupt discontinuation of the drug, if a state of stress is encountered, adrenal crisis can occur due to the lack of GCS in the body.

2) Rebound phenomenon and withdrawal symptoms.