Steroid use in the elderly. Guidelines for avoiding adverse effects.
The effects of aging on adrenal function should be considered when prescribing steroid for the elderly. For glucocorticoids, the changes of decreased production and decreased clearance are relatively balanced, resulting in levels that are still within the normal range. Responses of the hypothalamic-pituitary-adrenal axis to stress are not altered. However, androgens appear to be affected by an "adrenopause," the mechanism(s) and the clinical relevance of which remain to be elucidated. The risk/benefit factors in steroid use are always of utmost concern. The physician may consider lowering the steroid dose in elderly patients of asthenic build because of the diminution of muscle mass and plasma volume that occurs with aging. Despite the physiologic changes that accompany aging, steroid used carefully and appropriately can be both safe and effective in the elderly.
D000311:Adrenal Glands / Q000187:drug effects*; D000324:Adrenocorticotropic Hormone / Q000096:biosynthesis; D000368:Aged; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D006854:Hydrocortisone / Q000096:biosynthesis; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects; D010913:Pituitary-Adrenal System / Q000187:drug effects; D012306:Risk
D005938:Glucocorticoids; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone