12
Tables
Table 2. Overview of Topics Prescribing Clinicians Should
Discuss With Patients When Prescribing Oral
Glucocorticoids
Considerations Eligible patients Timing Comments
Risk for developing
exogenous Cushing
syndrome
All patients
on long-term
supraphysiologic
glucocorticoid
therapy
At the time of
initiation
ere are many
sequelae of exogenous
Cushing syndrome.
Patients should be
educated on the
most common and
clinically significant,
including weight
gain, sarcopenia,
hyperglycemia,
hypertension, bone
demineralization.
Risk for developing
chronic adrenal
insufficiency
Even transient adrenal
insufficiency requires
education to raise
awareness for the need
to stress dose when
appropriate
Education on stress
dosing strategies
Patients on
long-term
supraphysiologic
glucocorticoid
therapy who have
reduced dosing
to physiologic, or
subphysiologic,
levels.
At least at
the time
when dosing
approaches a
physiologic
range.
Dedicated education
should be provided to
prepare patients with
confirmed, or likely,
adrenal insufficiency
for routine and
emergent stress dosing.
Education on
injectable emergency
glucocorticoid
administration
Glucocorticoid
withdrawal
syndrome
Patients on
long-term
supraphysiologic
glucocorticoid
therapy who are
ready to begin
tapering the dose.
At the time
glucocorticoid
tapering begins
Some patients on long
term supraphysiologic
glucocorticoid therapy
experience symptoms
as the doses are
tapered.
