THE HYPOTHALAMIC-PITUITARY-ADRENAL CONNECTION
A defect at any point along the hypothalamic-pituitary-adrenal (HPA)-axis could disrupt normal physiologic glucocorticoid levels. Administration of exogenous glucocorticoids leads to suppression of cortisol production by the adrenal cortex.
HPA-axis suppression is a well-known adverse effect of glucocorticoid therapy; however, considerable controversy exists over the dose and duration of glucocorticoid therapy required to suppress the HPA-axis.
Some of the many factors that influence HPA-axis suppression include time of day that the doses are administered, route of administration, dose and duration of therapy, and duration of action of the agent used.
Reference: Helfer EL, Rose LI. Corticosteroids and adrenal suppression: characterizing and avoiding the problem. Drugs. 1989;38(5):838-845
HPA-axis suppression is a well-known adverse effect of glucocorticoid therapy; however, considerable controversy exists over the dose and duration of glucocorticoid therapy required to suppress the HPA-axis.
Some of the many factors that influence HPA-axis suppression include time of day that the doses are administered, route of administration, dose and duration of therapy, and duration of action of the agent used.
Reference: Helfer EL, Rose LI. Corticosteroids and adrenal suppression: characterizing and avoiding the problem. Drugs. 1989;38(5):838-845
