During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex. Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation. Although it has been shown that there is considerably less adrenal suppression following a single morning dose of prednisolone (10 mg) as opposed to a quarter of that dose administered every six hours, there is evidence that some suppressive effect on adrenal activity may be carried over into the following day when pharmacologic doses are used. Further, it has been shown that a single dose of certain corticosteroids will produce adrenal cortical suppression for two or more days. Other corticoids, including methylprednisolone, hydrocortisone, prednisone, and prednisolone, are considered to be short acting (producing adrenal cortical suppression for 1¼ to 1½ days following a single dose) and thus are recommended for alternate day therapy.
I’ve always had mitral valve prolapse with mild regurgitation and good blood pressure, until about 7 months ago when I went to the cardiologist for a check-up. My blood pressure was alarmingly high and my regurgitation had become moderate, I had a cough I couldn’t get rid of, and some swelling in my lower legs and ankles. For the next three months my medications were increased until my blood pressure was brought back to normal, but in the meantime I developed a tightness at the base of my throat and a (rice crispy) crackling in my chest when I would lay down. A ZPack and a steroid shot helped clear the crackling, but My family doctor was concerned about heart failure and requested a chest xray that showed scarring from what could have been a previous undiagnosed bout of pneumonia. This xray was repeated twice over the next two months, the second one showing the scarring improved but there was some atrial enlargement. The third one finally clear. My cardiologist was not interested in this what so ever, he saw no connection between my lung issues and my heart to be concerned about. Then a month ago the crackling returned with a strained voice and hoarseness, and it became harder to breathe. I went to an after hours clinic and their xray showed bilateral pneumonia. I was put on antibiotics and given a rescue inhaler and went to my family doctor the next day. He verified the pneumonia but was puzzled by my lack of a productive cough and fever. I took two weeks of antibiotics and improved greatly after a week, but then a week after my antibiotics were finished (3 weeks after pneumonia diagnosis) crackling and shortness of breath returned, the hoarseness never fully clear up. This time I went to a pulmonologist who was concerned that this all may be pulmonary hypertension, so he ordered blood work, xray, CT scan, and PFT. The results were a clear chest xray, a small non calcified nodule in one lung, bilateral bands of atelectasis, a slightly enlarged pulmonary artery, and my brain peptides were at 244. PFT results not available yet. I heard from pulmonologist today about these results and he said there was nothing alarming. He would see me in one month and redo the CT scan in one year. My question is should I be satisfied with this response? What questions should I ask, or should I push for more even seeking a second opinion from both another pulmonologist or cardiologist?
Inform your physician of all the medications you take (prescription and over the counter) and other medical conditions you have before taking a Medrol Dose Pack. If you are scheduled for surgery, the medical staff must be aware that you are on a Medrol Dose Pack. It never should be taken if you are allergic to methylprednisolone or have a fungal infection. Since steroids can weaken the immune system, avoid people who have colds and the flu. Contact your physician if you become exposed to the measles or chicken pox, as these illnesses can become serious when a person is on steroid medication.