[药物性肾上腺功能不全]。

Q4 Medicine
Praxis Pub Date : 2025-04-01 DOI:10.23785/PRAXIS.2025.04.005
Sofia Flores Borsari, Stefan Bilz
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引用次数: 0

摘要

导言:许多药物可不同程度地影响下丘脑-垂体-肾上腺轴(HPA-Axis)。自从1948年发现糖皮质激素(GC)的药理作用和可的松(当时称为“化合物E”)首次应用于类风湿关节炎患者以来,外源性糖皮质激素一直是药物性肾上腺皮质功能不全的最常见原因。近年来,免疫检查点抑制剂(ICI)已成为一个新的重要原因。由于潜伏和非特异性的症状,这也可能是潜在疾病及其治疗的结果,诊断往往被推迟。主治医生的定期筛查对于及时识别病情和减少相关发病率至关重要。本文总结了最常见的涉及药物(GC, ICI和阿片类药物)和相应的管理建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Drug-induced adrenal insufficiency].

Introduction: Many drugs may influence the hypothalamic-pituitary-adrenal axis (HPA-Axis) at different levels. Since the discovery of the pharmacological effect of glucocorticoids (GC) and the first application of cortisone (then known as "Compound E") in patients with rheumatoid arthritis in 1948, exogenous glucocorticoids have been the most common cause of drug-induced adrenocortical insufficiency. In the last few years, immune check point inhibitors (ICI) have become a new important cause. Due to the insidious and unspecific symptoms, which can also be a consequence of the underlying disease and its therapies, the diagnosis is often delayed. Regular screening by the attending physicians is essential for prompt recognition of the condition and reduction of the associated morbidity. This article summarizes the most common implicated drugs (GC, ICI and opioids) and the corresponding management recommendations.

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来源期刊
Praxis
Praxis Medicine-Medicine (all)
CiteScore
0.40
自引率
0.00%
发文量
146
审稿时长
12 weeks
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