How are glucocorticoids applied?

The glucocorticoid treatment plan should be formulated by integrating the patient’s condition and drug characteristics, and the treatment plan includes the selection of species, dose, treatment course and route of administration, etc. The pharmacodynamics and human pharmacokinetics (absorption, distribution, metabolism and excretion process) of various glucocorticoids are different, so they have different clinical indications, and glucocorticoids should be correctly selected according to the characteristics of different diseases and various glucocorticoids. The physiological and pharmacological doses of glucocorticoids have different effects, and the doses should be selected according to different therapeutic purposes. It is generally believed that the dose (taking prednisone as an example) can be divided into the following cases: (1) long-term maintenance dose: 2.5~15.0 mg/d; (2) small dose: <0.5 mg/kg-1/d-1; (3) medium dose: 0.5~1.0 mg/kg-1/d-1; (4) large dose: >1.0 mg/kg-1/d-1; (5) shock Dose: (for example, methylprednisolone) 7.5~30.0 mg/kg-1・d-1. 3.Course of treatment The course of glucocorticosteroid treatment differs from disease to disease and can be generally divided into the following cases: (1) Shock treatment: The course of treatment is mostly less than 5 days. It is suitable for the rescue of critically ill patients, such as fulminant infection, anaphylaxis, severe asthma persistence, allergic laryngeal edema, lupus encephalopathy, severe herpetic skin disease, severe drug rash, acute nephritis, etc. Shock therapy must be combined with other effective therapeutic measures and can be stopped quickly. If it is ineffective in most cases, shock therapy must not be repeated within a short period of time. (2) Short course of treatment: the course of treatment is less than 1 month, including stress treatment. It is suitable for infectious or allergic diseases, such as tuberculous meningitis and pleurisy, exfoliative dermatitis or acute rejection of organ transplantation. Short-course treatment must be combined with other effective therapeutic measures, and the dosage needs to be gradually reduced to discontinuation when stopping the drug. (3) Medium course treatment: within 3 months of treatment. It is suitable for diseases with long duration and multi-organ involvement, such as rheumatic fever. After taking effect, reduce to the maintenance dose, and gradually decrease when stopping the drug. (4) Long-term treatment: the course of treatment is more than 3 months. It is suitable for the prevention and treatment of rejection after organ transplantation and chronic autoimmune diseases with recurrent and multi-organ involvement, such as systemic lupus erythematosus, hemolytic anemia, systemic vasculitis, nodular disease, herpetic skin disease, etc. Maintenance therapy can be administered daily or every other day, and should also be gradually transitioned to every other day therapy before discontinuation. (5) Lifetime replacement therapy: Applicable to primary or secondary chronic hyperalgesia, and increase the dose appropriately in various stressful situations. 4. Route of administration includes systemic medication such as oral, intramuscular injection, intravenous injection or intravenous drip, and local medication such as inhalation, local injection, drip and application.