Postby MissMolly » Tue Jan 17, 2017 6:31 pm
SewHappy:
Just to give you some perspective on corticosteroids and dosing . . . .
Your adrenal glands produce, on average, about 15-20 mg of cortisol a day. The adrenal glands produce cortisol by direction of the pituitary gland, in a negative-feedback loop. Cortisol is the body's stress hormone, allowing the body to adjust and adapt to varying stressors. Cortisol is also a powerful anti-inflammatory agent. Every cell of the body depends on cortisol. Cortisol is life-essential.
1 mg of dexamethasone = approximately 20 mg hydrocortisone/cortisol.
In 1 mg of dexamethasone, you are receiving about the same equivalent of what your body produces of cortisol in an average/non-stressed day.
Dexamethasone is one of the more potent/concentrated corticosteroids (small dose = magnified effect). It is also one of the longer-acting of the available corticosteorids. The half-life of dexamethasone is 36-40 hours. Meaning it stays in your body's system for a long time before being fully excreted.
Prednisone, as a comparative, is an intermediate time frame acting corticosteroid. 1 mg prednisone = approximately 4 mg hydrocortisone/cortisol. The half-life of prednisone is 16-18 hours. The half-life is the time interval in which half of the dose remains metabolically active in the body.
The point/demonstration: Of the available corticosteorids, there is a gradation of potency and effect. At the lower end is hydrocortisone, followed by prednisone, prednisolone, and dexamethasone. Dexamethasone is a potent corticosteroid per unit dosage/volume. It also has a long half-life in the body (meaning that its effects continue over a longer time horizon).
There is always room for discussion with one's ordering physician for individual dosing regimens of corticosteroids. A one-size-fits-all dosing does not well fit each individual.
Someone with underlying glucose intolerance - as you have - will be especially vulnerable to the insulin releasing effects of exogenous corticosteroids. I would talk with your ordering physician to see if there is a lower dosing of the IV infusion bolus and/or oral post-infusion dexamethasone tablets available to you that will enable you to ameliorate distressing side-effects of your chemotherapy while keeping the propensity for increased release of insulin (and increased serum glucose) in check. Talk with your ordering physician and discuss your glucose spikes.
The best medical care is medical care that is individually tailored.
- Karen -
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.