Clonidine and beta-adrenoceptor antagonists are clinically the most important of these agents, but numerous other drugs have been implicated. Overall, the problem is small when viewed in the context of the huge scale of prescribing of antihypertensive medicines. A more serious problem is the occurrence of crescendo angina following the abrupt withdrawal of beta-adrenoceptor antagonists.
Although other factors may be involved, adaptive up-regulation of beta-adrenoceptor density is the most likely cause of crescendo angina, and renders the patient more susceptible to sympathetic nervous stimulation following withdrawal of treatment. Will I need to take any special precautions while being treated with steroids?
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At this time, steroids are the only medicines known to help to maintain strength and function for people living with Duchenne. If you do make the decision to stop taking steroids, it is important that you do so under the supervision of a medical provider preferably, the prescribing medical provider and follow the corticosteroid therapy withdrawal guidelines outlined in the PJ Nicholoff Steroid Protocol download.
Watch very carefully for signs of life-threatening adrenal crisis during the corticosteroid taper, and for one year post-taper during times of serious injury or illness. Missing doses of daily steroids for more than 24 hours can also cause life-threatening adrenal crisis. If oral corticosteroids are missed on days when they are normally given for more than 24 hours, IV doses should be given.
Be sure to share the PJ Nicholoff Steroid Protocol download with your doctor and create a plan together about what to do in case of a missed dose. Recommendations for supplemental stress doses are provided in the PJ Nicholoff Steroid Protocol download.
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