When and how to start and discontinue corticosteroid treatment in palliative care?

Maciej Bączyk

Vol 3, No 2 (2004): Polish Palliative Medicine

Artykuły poglądowe

Published online: 2004-04-09

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When and how to start and discontinue corticosteroid treatment in palliative care?

Maciej Bączyk

Advances in Palliative Medicine 2004;3(2):171-178.

Vol 3, No 2 (2004): Polish Palliative Medicine

Artykuły poglądowe

Published online: 2004-04-09

Abstract

Glucocorticosteroids are widely used in palliative care. In the case of specific indications, they are the drugs of choice and we assume a priori the need for long-term administration, even over several months, until the patient’s death. In the case of non-specific indications, administration should be scheduled over approximately 3–4 weeks, because in many patients, after the initial improvement, the therapeutic effect decreases despite continued use, while there is a growing risk of undesirable side effects and lasting HPA axis suppression. In patients receiving long-term oral corticosteroid treatment, even a considerable deterioration of the patient’s overall condition does not excuse failure to replace it with parenteral corticosteroid administration, both for specific and non-specific indications.