{"id":319,"date":"2024-08-06T13:47:58","date_gmt":"2024-08-06T13:47:58","guid":{"rendered":"https:\/\/www.zavislostnakortikoidoch.sk\/?page_id=319"},"modified":"2024-10-16T12:04:14","modified_gmt":"2024-10-16T12:04:14","slug":"neziaduce-ucinky","status":"publish","type":"page","link":"https:\/\/www.zavislostnakortikoidoch.sk\/?page_id=319","title":{"rendered":"Ne\u017eiad\u00face \u00fa\u010dinky"},"content":{"rendered":"

[et_pb_section fb_built=“1″ admin_label=“Testimonial“ _builder_version=“4.23.2″ _module_preset=“default“ background_color=“gcid-606d042f-c90f-4ea6-97e7-7b08f1ba25f6″ custom_padding=“0px||0px||true|false“ locked=“off“ collapsed=“on“ global_colors_info=“{%22gcid-606d042f-c90f-4ea6-97e7-7b08f1ba25f6%22:%91%22background_color%22%93}“][et_pb_row column_structure=“1_2,1_2″ make_equal=“on“ _builder_version=“4.23.2″ _module_preset=“default“ custom_padding=“0px||0px||true|false“ global_colors_info=“{}“][et_pb_column type=“1_2″ _builder_version=“4.20.0″ _module_preset=“default“ global_colors_info=“{}“][et_pb_image src=“https:\/\/www.zavislostnakortikoidoch.sk\/wp-content\/uploads\/2024\/07\/iStock-521382700.jpg“ title_text=“Medicine – Side Effects – Drugs“ _builder_version=“4.23.2″ _module_preset=“default“ custom_margin=“|||-10vw|false|false“ custom_margin_tablet=“|-10vw||-10vw|false|true“ custom_margin_phone=“|-10vw||-10vw|false|true“ custom_margin_last_edited=“on|tablet“ border_color_all=“#F9F6F1″ border_width_top=“3vw“ border_width_right=“3vw“ border_width_top_tablet=“10vw“ border_width_top_phone=“10vw“ border_width_top_last_edited=“on|tablet“ border_width_right_tablet=“10vw“ border_width_right_phone=“10vw“ border_width_right_last_edited=“on|tablet“ locked=“off“ global_colors_info=“{}“][\/et_pb_image][\/et_pb_column][et_pb_column type=“1_2″ _builder_version=“4.23.2″ _module_preset=“default“ custom_padding=“12%||||false|false“ global_colors_info=“{}“][et_pb_text _builder_version=“4.23.2″ _module_preset=“f9d2dd7a-275e-489f-8ad5-d86fc2004b41″ header_2_text_color=“#FFFFFF“ global_colors_info=“{}“]<\/p>\n

Ne\u017eiad\u00face \u00fa\u010dinky kortikoidov<\/h2>\n

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Prv\u00e9 \u0161t\u00fadie o ne\u017eiad\u00facich \u00fa\u010dinkoch dlhodob\u00e9ho pou\u017e\u00edvania kortikosteroidov boli publikovan\u00e9 u\u017e v 90. rokoch, no napriek tomu je o nich slab\u00e1 informovanos\u0165.<\/p>\n

Z\u00e1vislos\u0165 na nich a TSW syndr\u00f3m si pre\u017eili tis\u00edcky pacientov po celom svete, ich pr\u00edpady s\u00fa zastre\u0161en\u00e9 celosvetovou organiz\u00e1ciu ITSAN<\/span><\/strong>, ale povedomie sa \u0161\u00edri najm\u00e4 cez jednotlivcov, ktor\u00ed za\u017e\u00edvaj\u00fa ne\u017eiad\u00face \u00fa\u010dinky na vlastnej ko\u017ei, a to doslova.<\/span><\/a><\/span><\/span><\/strong><\/span><\/p>\n

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Ne\u017eiad\u00face \u00fa\u010dinky<\/h1>\n

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Atrofia – sten\u0161ovanie ko\u017ee inhib\u00edciou d\u00f4le\u017eit\u00fdch l\u00e1tok, ktor\u00e9 s\u00fa pr\u00edtomn\u00e9 v zdravej ko\u017ei<\/h3>\n

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Pou\u017e\u00edvanie KK m\u00e1 inhibi\u010dn\u00fd \u00fa\u010dinok na prolifer\u00e1ciu keratinocytov v epiderme.
Tie\u017e doch\u00e1dza k inhib\u00edcii synt\u00e9zy kolag\u00e9nu<\/strong> 1 a 3, k inhib\u00edcii fibroblastov a enz\u00fdmu hyalur\u00f3nan synt\u00e1za 3 vedie k zn\u00ed\u017eeniu kyseliny hyalur\u00f3novej v extracelul\u00e1rnej matrici, \u010do vedie k derm\u00e1lnej atrofii.<\/strong> Epidermis sa sklad\u00e1 z keratinocytov a dermis sa sklad\u00e1 hlavne z fibroblastov. Prolifer\u00e1cia a synt\u00e9za prote\u00ednov potrebn\u00fdch na tvorbu\u00a0 keratinocytov a fibroblastov s\u00fa v\u0161ak d\u00f4ledkom pou\u017e\u00edvania KK potla\u010den\u00e9.<\/p>\n

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Schoepe S., Sch\u00e4cke H., May E., Asadullah K. Glucocorticoid therapy-induced skin atrophy. <\/span>Exp Dermatol<\/em>.\u00a0<\/span>2006;15<\/span>:406\u201320.<\/span>\u00a0<\/span><\/p>\n

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Tie\u017e s\u00fa redukovan\u00e9 medzibunkov\u00e9 lipidov\u00e9 vrstvy, ako s\u00fa ceramidy, cholesterol a mastn\u00e9 kyseliny. Ko\u017ea str\u00e1ca svoju bari\u00e9rov\u00fa funkciu, svoju pevnos\u0165 v \u0165ahu a elasticitu sp\u00f4soben\u00fa stratou vody. Modr\u00e1 \u010diara na obr\u00e1zku zn\u00e1zor\u0148uje ako je v atrofovanej ko\u017ei zv\u00fd\u0161en\u00e1 transepiderm\u00e1lna strata vody.<\/p>\n

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Zv\u00fd\u0161enie hmotnosti a riziko cukrovky<\/h3>\n

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Dlhodob\u00e9 pou\u017e\u00edvanie kortikosteroidov m\u00f4\u017ee vies\u0165 k zv\u00fd\u0161en\u00fdm hladin\u00e1m gluk\u00f3zy v krvi a pri dlhodobom pou\u017e\u00edvan\u00ed sa m\u00f4\u017ee rozvin\u00fa\u0165 cukrovka typu 2. – Diabetes Mellitus 2, obezita, Cushingov syndr\u00f3m, chradnutie svalov, steat\u00f3za pe\u010dene \u010di hypertenzia.<\/p>\n

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Hwang J.L., Weiss R.E. Steroid-induced diabetes: a clinical and molecular approach to understanding and treatment. Diabetes Metab Res Rev.<\/em> 2014 Feb; 30(2): 96\u2013102.<\/p>\n

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Moja sk\u00fasenos\u0165<\/strong><\/p>\n

Napriek tomu, \u017ee som sa zdravo stravovala, v posledn\u00fdch rokoch som evidovala n\u00e1rast hmotnosti. Chodila som 2x do t\u00fd\u017ed\u0148a do posil\u0148ovne, no takzvan\u00e9 hormon\u00e1lne brucho som mala neust\u00e1le. Po vysaden\u00ed KK som rapidne schudla, aj z d\u00f4vodu, \u017ee som sa neh\u00fdbala kv\u00f4li bolesti, ale aj kv\u00f4li hormon\u00e1lnej nerovnov\u00e1he v mojom tele. Po \u00faprave horm\u00f3nov, ktor\u00e9 sa stalo prirodzene v \u010dase po vysaden\u00ed KK mast\u00ed, v\u00e1ha ostala stabilizovan\u00e1 a tuk sa u\u017e v bruchu opakovane nehromad\u00ed.<\/span><\/p>\n

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Negat\u00edvna v\u00e1pnikov\u00e1 bilancia a osteopor\u00f3za\u00a0<\/h3>\n

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Najv\u00fdznamnej\u0161\u00edm ne\u017eiaducim \u00fa\u010dinkom glukokortikoidn\u00fdch liekov je rozvoj osteopor\u00f3zy.<\/strong> Glukokortikoidy zni\u017euj\u00fa absorpciu v\u00e1pnika v \u010drev\u00e1ch a obli\u010dkov\u00fdch tubuloch, \u010do vedie k zv\u00fd\u0161en\u00fdm strat\u00e1m v\u00e1pnika a fosf\u00e1tu mo\u010dom. Negat\u00edvna v\u00e1pnikov\u00e1 bilancia sp\u00f4sobuje postupn\u00fd \u00fabytok kostnej hmoty, \u010do zni\u017euje hustotu kost\u00ed o 10-40 %.<\/strong> Zlomeniny sa vyskytuj\u00fa asi u 30 % jedincov, ktor\u00ed KK u\u017e\u00edvaj\u00fa v priemere 5 rokov. Strata kostnej hmoty je reverzibiln\u00e1 po preru\u0161en\u00ed lie\u010dby glukokortikoidmi.<\/p>\n

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Caniggia A. et al., Pathophysiology of the adverse effects of glucoactive corticosteroids on calcium metabolism in man. Journal of Steroid Biochemistry<\/em>. Vol. 15,\u00a0<\/span>December 1981<\/span>, Pages 153-161<\/span><\/p>\n

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Vitam\u00edn D<\/strong><\/p>\n

Glukokortikoidy m\u00f4\u017eu tie\u017e zvy\u0161ova\u0165 produkciu parathorm\u00f3nu, \u010do vedie k demineraliz\u00e1cii kost\u00ed a naru\u0161eniu rovnov\u00e1hy vitam\u00ednu D. Parathorm\u00f3n stimuluje prechod vitam\u00ednu D na jeho akt\u00edvnu formu, kalcitriol, ktor\u00e9ho synt\u00e9za m\u00f4\u017ee by\u0165 priamo zn\u00ed\u017een\u00e1 glukokortikoidmi v obli\u010dk\u00e1ch. Tento nedostatok vitam\u00ednu D n\u00e1sledne zhor\u0161uje mineraliz\u00e1ciu kost\u00ed a zvy\u0161uje riziko osteopor\u00f3zy.<\/p>\n

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Davidson. Z.E. et al., Do Glucocorticosteroids Alter Vitamin D Status? A Systematic Review with Meta-Analyses of Observational Studies. The Journal of Clinical Endocrinology & Metabolism<\/em>, Volume 97, Issue 3, 1 March 2012, Pages 738\u2013744<\/span><\/p>\n

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Kortikosteroidy zvy\u0161uj\u00fa riziko bakteri\u00e1lnych a v\u00edrusov\u00fdch infekci\u00ed<\/h3>\n

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Kortikosteroidy potl\u00e1\u010daj\u00fa imunitn\u00fd syst\u00e9m<\/strong> t\u00fdm, \u017ee inhibuj\u00fa funkciu r\u00f4znych imunitn\u00fdch buniek, najm\u00e4 T-lymfocytov a makrof\u00e1gov. Tieto bunky zohr\u00e1vaj\u00fa k\u013e\u00fa\u010dov\u00fa \u00falohu v rozpozn\u00e1van\u00ed a boji proti infekci\u00e1m sp\u00f4soben\u00fdm bakt\u00e9riami a v\u00edrusmi. Ke\u010f je ich funkcia potla\u010den\u00e1, schopnos\u0165 tela vytvori\u0165 \u00fa\u010dinn\u00fa imunitn\u00fa odpove\u010f proti patog\u00e9nom je oslaben\u00e1.<\/p>\n

Zmena funkcie leukocytov<\/strong>: Kortikosteroidy m\u00f4\u017eu meni\u0165 funkciu bielych krviniek (leukocytov), ktor\u00e9 s\u00fa k\u013e\u00fa\u010dov\u00e9 v boji proti infekci\u00e1m. Napr\u00edklad, m\u00f4\u017eu zhor\u0161i\u0165 migr\u00e1ciu neutrofilov (druh bielych krviniek) na miesto infekcie, \u010d\u00edm zni\u017euj\u00fa schopnos\u0165 tela \u00fa\u010dinne eliminova\u0165 patog\u00e9ny.<\/p>\n

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Youssef J. et al., Infection Risk and Safety of Corticosteroid Use. Rheum Dis Clin North Am<\/em>. 2016 Feb; 42(1): 157\u2013176.<\/p>\n

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Youssef J. et al., Infection Risk and Safety of Corticosteroid Use. Rheum Dis Clin North Am<\/em>. 2016 Feb; 42(1): 157\u2013176.<\/p>\n

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Zn\u00ed\u017eenie z\u00e1palov\u00fdch odpoved\u00ed<\/strong>: KK s\u00fa siln\u00e9 protiz\u00e1palov\u00e9 l\u00e1tky. Hoci je to prospe\u0161n\u00e9 pri lie\u010dbe z\u00e1palov\u00fdch stavov, znamen\u00e1 to aj to, \u017ee typick\u00e9 pr\u00edznaky infekcie (ako hor\u00fa\u010dka, za\u010dervenanie, opuch) m\u00f4\u017eu by\u0165 tlmen\u00e9 alebo maskovan\u00e9.<\/p>\n

Z\u00e1pal je prirodzenou a nevyhnutnou s\u00fa\u010das\u0165ou procesu hojenia v tele. Ke\u010f s\u00fa tkaniv\u00e1 poranen\u00e9 alebo infikovan\u00e9, imunitn\u00fd syst\u00e9m reaguje spusten\u00edm z\u00e1palu.<\/strong> T\u00e1to z\u00e1palov\u00e1 reakcia pom\u00e1ha izolova\u0165 postihnut\u00fa oblas\u0165, odstr\u00e1ni\u0165 po\u0161koden\u00e9 bunky, patog\u00e9ny a za\u010da\u0165 opravu tkan\u00edv. Z\u00e1pal zvy\u010dajne zah\u0155\u0148a zv\u00fd\u0161en\u00fd prietok krvi, opuch, teplo a niekedy boles\u0165. V\u0161etky tieto pr\u00edznaky nazna\u010duj\u00fa, \u017ee telo akt\u00edvne pracuje na uzdraven\u00ed. Preto, aj ke\u010f z\u00e1pal m\u00f4\u017ee by\u0165 nepr\u00edjemn\u00fd, sl\u00fa\u017ei d\u00f4le\u017eit\u00e9mu \u00fa\u010delu v prirodzen\u00fdch mechanizmoch hojenia tela. Je nutn\u00e9 pristupova\u0165 k z\u00e1palu celostne a eliminova\u0165 ho v tele napr\u00edklad di\u00e9tou.<\/strong><\/p>\n

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[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=“1″ admin_label=“About“ _builder_version=“4.23.2″ _module_preset=“default“ background_color=“gcid-de71f7e9-c73d-4bf6-9384-53a89cf199ff“ custom_margin=“||||false|false“ custom_padding=“0px||0px||true|false“ collapsed=“on“ global_colors_info=“{%22gcid-de71f7e9-c73d-4bf6-9384-53a89cf199ff%22:%91%22background_color%22%93}“][et_pb_row column_structure=“1_2,1_2″ _builder_version=“4.20.0″ _module_preset=“default“ custom_padding=“0px||0px||true|false“ global_colors_info=“{}“][et_pb_column type=“1_2″ _builder_version=“4.20.0″ _module_preset=“default“ global_colors_info=“{}“][et_pb_image src=“https:\/\/www.zavislostnakortikoidoch.sk\/wp-content\/uploads\/2024\/07\/iStock-2032150750.jpg“ title_text=“The man’s hand, he uses steroids Apply External type“ _builder_version=“4.23.2″ _module_preset=“default“ custom_margin=“|||-10vw|false|false“ custom_margin_tablet=“|-10vw||-10vw|false|true“ custom_margin_phone=“|-10vw||-10vw|false|true“ custom_margin_last_edited=“on|tablet“ border_color_all=“#8a8569″ border_width_top=“3vw“ border_width_right=“3vw“ border_width_top_tablet=“10vw“ border_width_top_phone=“10vw“ border_width_top_last_edited=“on|tablet“ border_width_right_tablet=“10vw“ border_width_right_phone=“10vw“ border_width_right_last_edited=“on|tablet“ global_colors_info=“{}“][\/et_pb_image][\/et_pb_column][et_pb_column type=“1_2″ _builder_version=“4.20.0″ _module_preset=“default“ custom_padding=“8%||8%||true|true“ global_colors_info=“{}“][et_pb_text _builder_version=“4.23.2″ _module_preset=“21761a19-4b90-44f7-803d-c04d150f50cd“ custom_margin=“||10px||false|false“ custom_padding=“||14px||false|false“ locked=“off“ global_colors_info=“{}“]<\/p>\n

Kortikosteroidy, l\u00e1tky s vysokou mierou z\u00e1vislosti<\/h3>\n

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V pr\u00edbalovom let\u00e1ku kortikosteroidn\u00fdch kr\u00e9mov sa zvy\u010dajne odpor\u00fa\u010da pou\u017e\u00edvanie 5-10 dn\u00ed, aby sa minimalizovalo riziko ved\u013eaj\u0161\u00edch \u00fa\u010dinkov spojen\u00fdch s dlhodob\u00fdm pou\u017e\u00edvan\u00edm, ako je sten\u010denie ko\u017ee, strie a in\u00e9 potenci\u00e1lne syst\u00e9mov\u00e9 \u00fa\u010dinky.\u00a0<\/strong><\/p>\n

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V lek\u00e1rskych postupoch je v\u0161ak zahrnut\u00e9 opakovan\u00e9 kr\u00e1tkodob\u00e9 pou\u017eitie s prest\u00e1vkami medzi nimi, aby sa u pacienta zvl\u00e1dli vzplanutia – z\u00e1palov\u00fdch procesov ko\u017en\u00fdch ochoren\u00ed a z\u00e1rove\u0148 minimalizovali riziko ved\u013eaj\u0161\u00edch \u00fa\u010dinkov. TSW syndr\u00f3m sa objavuje aj u pacientov, ktor\u00ed pou\u017e\u00edvali KK e\u0161te menej ako je odpor\u00fa\u010dan\u00e9 (menej ako 3 dni pou\u017eitia KK, 2-3 t\u00fd\u017edne pauza) no predsa do\u0161lo k z\u00e1vislosti.<\/strong><\/p>\n

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S\u00fa lek\u00e1rske protokoly dostato\u010dn\u00e9, aby sa u pacienta nevytvorila z\u00e1vislos\u0165?<\/h3>\n

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Pod\u013ea \u0161t\u00fadi\u00ed sleduj\u00facich spr\u00e1vne pou\u017e\u00edvanie KK sa odpor\u00fa\u010da pou\u017e\u00edvanie stredne a silne potentn\u00fdch kr\u00e9mov, ktor\u00e9 s\u00fa \u00fa\u010dinnej\u0161ie. Z 2266 \u00fa\u010dastn\u00edkov bolo identifikovan\u00fdch iba 26 pr\u00edpadov abnorm\u00e1lneho sten\u010denia ko\u017ee, ale je potrebn\u00e9 podotkn\u00fa\u0165, \u017ee \u0161t\u00fadia trvala menej ako 6 mesiacov. \u0160t\u00fadie na dlhodobej\u0161ie pou\u017e\u00edvanie KK ch\u00fdbaj\u00fa.\u00a0<\/strong><\/p>\n

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\u00a0Lax J.S.<\/span> Strategies for using topical corticosteroids in children and adults with eczema. Cochrane Database Syst Rev. 2022; 2022(3). URL 1<\/a><\/span><\/p>\n

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Vo v\u00e4\u010d\u0161ine pr\u00edpadov je predpisovan\u00fd pacientom stredne potentn\u00fd kr\u00e9m opakovane v \u010dase. Atopick\u00fd ekz\u00e9m sa prejavuje periodick\u00fdmi vzplanutiami, a tak v\u00e4\u010d\u0161ina siahne po kr\u00e9me pri \u010fal\u0161om vzplanut\u00ed znovu. V\u00fdrobcovia klad\u00fa zodpovednos\u0165 na lek\u00e1rov, aby ur\u010dili periodicitu pou\u017e\u00edvania pod\u013ea stavu ka\u017ed\u00e9ho pacienta, ale lek\u00e1rske postupy a syst\u00e9m je nastaven\u00fd tak, aby bol kr\u00e9m opakovane predp\u00edsan\u00fd. Predsa KK len potla\u010duj\u00fa prejavy z\u00e1palu, ale nehoja, tak\u017ee vieme 100% predv\u00edda\u0165, \u017ee sa vzplanutie objav\u00ed opakovane. Ka\u017ed\u00fd atopik pou\u017e\u00edvaj\u00faci kr\u00e9my potvrd\u00ed, \u017ee naj\u00fa\u010dinej\u0161ie s\u00fa KK, a tak znovu po nich siah\u00e1.<\/strong><\/p>\n<\/blockquote>\n

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Pod\u013ea online dotazn\u00edku na 105 respondentoch, ktor\u00ed pou\u017e\u00edvaj\u00fa\/pou\u017e\u00edvali kortikoidy, je miera naplnenia krit\u00e9ri\u00ed z\u00e1vislosti vo v\u00fdskume 78,85%.<\/strong> Data s\u00fa s\u00fa\u010das\u0165ou bakal\u00e1rskej pr\u00e1ce pani Bc. Zuzany Krotilovej s n\u00e1zvom Odvykac\u00ed stav od kortikoid\u016f a syndrom z\u00e1vislosti: dotazn\u00edkov\u00e9 \u0161et\u0159en\u00ed a<\/a>
kazuistiky.<\/a><\/p>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=“1″ admin_label=“FAQ“ _builder_version=“4.20.0″ _module_preset=“default“ collapsed=“on“ global_colors_info=“{}“][et_pb_row column_structure=“1_3,2_3″ _builder_version=“4.23.2″ _module_preset=“default“ global_colors_info=“{}“][et_pb_column type=“1_3″ _builder_version=“4.20.0″ _module_preset=“default“ global_colors_info=“{}“][et_pb_image src=“https:\/\/www.zavislostnakortikoidoch.sk\/wp-content\/uploads\/2024\/08\/carolina-heza-zwPYmB1GlNE-unsplash-scaled.jpg“ title_text=“carolina-heza-zwPYmB1GlNE-unsplash“ _builder_version=“4.23.2″ _module_preset=“default“ global_colors_info=“{}“][\/et_pb_image][\/et_pb_column][et_pb_column type=“2_3″ _builder_version=“4.20.0″ _module_preset=“default“ global_colors_info=“{}“][et_pb_accordion _builder_version=“4.23.2″ _module_preset=“4e75aedf-7505-46c3-a025-e9bb706c9fab“ custom_margin=“-4px|||||“ locked=“off“ global_colors_info=“{%22gcid-606d042f-c90f-4ea6-97e7-7b08f1ba25f6%22:%91%22toggle_text_color%22,%22body_text_color%22,%22toggle_text_color%22,%22body_text_color%22,%22toggle_text_color%22,%22body_text_color%22,%22toggle_text_color%22,%22body_text_color%22,%22toggle_text_color%22,%22body_text_color%22,%22toggle_text_color%22,%22body_text_color%22,%22toggle_text_color%22,%22body_text_color%22,%22toggle_text_color%22,%22body_text_color%22,%22toggle_text_color%22,%22body_text_color%22,%22toggle_text_color%22,%22body_text_color%22,%22toggle_text_color%22,%22body_text_color%22,%22toggle_text_color%22,%22body_text_color%22%93,%22gcid-7a02f245-10cf-4ba2-ac73-385345b5f54a%22:%91%22body_link_text_color%22,%22body_link_text_color%22,%22body_link_text_color%22,%22body_link_text_color%22,%22body_link_text_color%22,%22body_link_text_color%22,%22body_link_text_color%22,%22body_link_text_color%22,%22body_link_text_color%22,%22body_link_text_color%22,%22body_link_text_color%22,%22body_link_text_color%22%93,%22gcid-803cbec3-ce51-4865-83f1-75b1ba8d83fc%22:%91%22border_color_all%22,%22border_color_all%22,%22border_color_all%22,%22border_color_all%22,%22border_color_all%22,%22border_color_all%22,%22border_color_all%22,%22border_color_all%22,%22border_color_all%22,%22border_color_all%22,%22border_color_all%22%93}“][et_pb_accordion_item title=“Lok\u00e1lna z\u00e1vislos\u0165 na steroidoch (TSA)“ open=“on“ _builder_version=“4.23.2″ _module_preset=“default“ custom_padding=“|0px||0px|false|true“ global_colors_info=“{}“]<\/p>\n

TSA je charakterizovan\u00e1 nekontrolovate\u013enou, \u0161\u00edriacou sa dermatit\u00eddou a zhor\u0161uj\u00facim sa z\u00e1palom ko\u017ee, \u010do si vy\u017eaduje silnej\u0161\u00ed lok\u00e1lny steroid, aby sa dosiahol rovnak\u00fd v\u00fdsledok ako pri prvom predpise. Tento cyklus je zn\u00e1my ako syndr\u00f3m z\u00e1vislosti na steroidoch.<\/span><\/p>\n

[\/et_pb_accordion_item][et_pb_accordion_item title=“Nedostato\u010dn\u00e1 klinick\u00e1 valid\u00e1cia lie\u010diva“ _builder_version=“4.23.2″ _module_preset=“default“ custom_padding=“|0px||0px|false|true“ global_colors_info=“{}“ open=“off“]<\/p>\n

Pod\u013ea dostupn\u00fdch d\u00e1t nie je preuk\u00e1zan\u00e1 dostato\u010dn\u00e1 klinick\u00e1 valid\u00e1cia kortikoidn\u00fdch kr\u00e9mov pri pou\u017e\u00edvan\u00ed viacej ako 6-12 mesiacov. Taktie\u017e pr\u00edbalov\u00e9 let\u00e1ky neobsahuj\u00fa \u0161pecifickej\u0161ie inform\u00e1cie. V dne\u0161nej dobe sa pravidl\u00e1 pre registr\u00e1ciu lie\u010div spr\u00eds\u0148uj\u00fa, av\u0161ak v minulosti podrobnej\u0161ie inform\u00e1cie o pou\u017eit\u00ed nemuseli by\u0165 \u0161pecifikovan\u00e9.<\/span><\/p>\n

[\/et_pb_accordion_item][et_pb_accordion_item title=“Pol\u010das rozpadu kortikosteroidov“ _builder_version=“4.23.2″ _module_preset=“default“ global_colors_info=“{}“ open=“off“]<\/p>\n

Pol\u010das znamen\u00e1 ko\u013eko trv\u00e1, k\u00fdm sa polovica l\u00e1tky\u00a0 metabolizuje v tele. K dispoz\u00edcii je nieko\u013eko KK, ka\u017ed\u00fd s r\u00f4znou \u00fa\u010dinnos\u0165ou. Dexametaz\u00f3n a betametaz\u00f3n s\u00fa dlhodobo p\u00f4sobiace s najvy\u0161\u0161ou glukokortikoidnou \u00fa\u010dinnos\u0165ou s biologick\u00fdm pol\u010dasom 36 a\u017e 54 hod\u00edn. Kortiz\u00f3n a kortizol p\u00f4sobia kr\u00e1tkodobo s biologick\u00fdm pol\u010dasom menej ako 12 hod\u00edn, ke\u010f\u017ee nie s\u00fa tak \u00fa\u010dinn\u00e9 \u010dasto sa nepou\u017e\u00edvaj\u00fa. Pri stredne potentn\u00fdch kr\u00e9moch a \u010dastom pou\u017e\u00edvan\u00ed sa \u00fa\u010dinn\u00e9 l\u00e1tky nedok\u00e1\u017eu z tela dostato\u010dne r\u00fdchlo metabolizova\u0165. \u00a0(Yasir M. et all., <\/span>Corticosteroid Adverse Effects. StatPearls Publishing<\/em>; 2024 URL1<\/a><\/span><\/span><\/p>\n

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Ka\u017ed\u00e9mu \u010dloveku, ktor\u00fd si prech\u00e1dza TSW syndr\u00f3mom prajem ve\u013ea s\u00edl! Ver, \u017ee raz prejde\u0161 po pomyselnom moste zdravotn\u00fdch \u0165a\u017ekost\u00ed na druh\u00fa stranu, kde bude\u0161 zdrav\u00fd a tvoja poko\u017eka bude v poriadku.\u00a0<\/em><\/strong><\/p>\n

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Prihl\u00e1s sa na odber, a\u017e ti neunikn\u00fa \u010fal\u0161ie<\/span><\/strong><\/h3>\n

inform\u00e1cie z TSW komunity.<\/span><\/strong><\/h3>\n

[\/et_pb_text][et_pb_signup mailchimp_list=“undefined|elegantthemestest|1ea2bbd026″ first_name_field=“off“ last_name_field=“off“ button_text=“Odosla\u0165“ _builder_version=“4.23.2″ _module_preset=“cdc6fe58-a26f-4d12-af2b-da2dae6e31ac“ form_field_background_color=“rgba(255,255,255,0.54)“ form_field_text_color=“#FFFFFF“ form_field_focus_background_color=“RGBA(255,255,255,0)“ border_width_all_fields=“0px“ locked=“off“ global_colors_info=“{%22gcid-606d042f-c90f-4ea6-97e7-7b08f1ba25f6%22:%91%22button_bg_color%22,%22border_color_all%22,%22border_color_all_fields%22,%22button_bg_color%22,%22border_color_all%22%93}“][\/et_pb_signup][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"

Ne\u017eiad\u00face \u00fa\u010dinky kortikoidovPrv\u00e9 \u0161t\u00fadie o ne\u017eiad\u00facich \u00fa\u010dinkoch dlhodob\u00e9ho pou\u017e\u00edvania kortikosteroidov boli publikovan\u00e9 u\u017e v 90. rokoch, no napriek tomu je o nich slab\u00e1 informovanos\u0165. 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