Prednisolone Flashcards

1
Q

What precautions should be taken during the tooth extraction process for a patient on prednisone?

A

For a patient taking prednisone long-term, the following precautions should be taken during tooth extraction:

  1. Consult the patient’s physician to evaluate the need for steroid supplementation before the extraction. to prevent adrenal crisis during the surgical procedure.
  2. Minimize anxiety and stress during the extraction process, as this can also impact the body’s stress response in these patients.
  3. Consider using prophylactic antibiotics to prevent infection, as prednisone can impair the immune system and wound healing.
  4. Monitor the patient closely for any signs of delayed healing or infection after the extraction, and provide appropriate follow-up care.
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2
Q

stress-dose steroids

A

Steroid supplementation

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3
Q

Who is authorized to change a patient’s steroid dose?

A

Physicians

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4
Q

Adrenal suppression or
adrenal insufficiency

A

a condition where the adrenal glands do not produce sufficient cortisol in response to stress due to long-term use of corticosteroids like prednisone or prednisolone.

Secondary Adrenal Insufficiency: This is because exogenous steroids suppress the hypothalamic-pituitary-adrenal (HPA) axis. (trục hạ đồi-tuyến yên-tuyến thượng thận)

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5
Q

“rule of 2” for Adrenal suppression

A

Adrenal suppression risk occurs if the patient has taken corticosteroids for more than 2 weeks within the last 2 years at doses equivalent to 20 mg hydrocortisone or 5 mg prednisolone daily.

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6
Q

Symptoms of Adrenal Insufficiency:

A

Fatigue, weakness
Nausea, vomiting
Low blood pressure
Hypoglycemia
In severe cases: Adrenal crisis (life-threatening) = collapse (Cardiovascular collapse), or shock (Electrolyte imbalances).

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7
Q

Long-term use of corticosteroids: Implications for Dental and Surgical Procedures:

A
  1. Stressful procedures can precipitate adrenal insufficiency
  2. Prednisone suppresses the immune system and inhibits collagen synthesis, which can delay soft tissue healing and osseointegration
  3. Long-term corticosteroid use can lead to secondary osteoporosis,
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8
Q

discover it by chance

A

phát hiện ra nó một cách tình cờ.

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