the objective for most pts is relieve symptoms to acceptable level, complete relief may not be goal.
control the level so pt can be comfy but may not be a cure.
usually start low and titrate up and slowly titrate down- allows the body to say i don't have enough cortisol...
at times of stress may need to be increased.
admin at scheduled time- follow body arcardian level- follow body secretion of cortisol- peaks in the am 6-8am (best time before 9am)
- Day therapy used primarily for children
- - decrease adrenal insufficiency- bc it allows body time to make cortisol
- - decreas the risk of growth retardation (effects long bones and muscles, alters protein synthesis)- impact wt/h
- - decrease risk of toxicity