Suppression of the hypothalamus-pituitary axis can occur. Exogenous steroids extert negative feedback in the same way that endogenous steroids do. This leads to suppression of ACTH formation and storage and may cause atrophy of the pituitary gland. Sudden termination of treatment with exogenous steroids can therefore lead to failure of production of endogenous steroids, causing a crisis. This means that gradual dose reduction is of paramount importance. One method of achieving this is by alternate day thereapy, where a short-acting glucocorticoid in a short-acting formulation us used every other day at times to conincide with peak endogenous steroid levels. | Suppression of the hypothalamus-pituitary axis can occur. Exogenous steroids extert negative feedback in the same way that endogenous steroids do. This leads to suppression of ACTH formation and storage and may cause atrophy of the pituitary gland. Sudden termination of treatment with exogenous steroids can therefore lead to failure of production of endogenous steroids, causing a crisis. This means that gradual dose reduction is of paramount importance. One method of achieving this is by alternate day thereapy, where a short-acting glucocorticoid in a short-acting formulation us used every other day at times to conincide with peak endogenous steroid levels. |