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Diseases of the Bones and Joints

Diseases of the Bones and Joints By ROBERT M. STECHER Department of Medicine, Western Reserve University; School of Medicine at City Hospital, Cleveland Ohio CORTISONE AND ACTH2 Any discussion of rheumatoid arthritis always brings up for consideration cortisone and its derivatives. After nearly six years of experience the drug is recognized as a substance with effective therapeutic activities as well as a potent agent for control of pain. Despite all the dire promises formerly made, cortisone properly used does not ablate adrenal activity or produce complete diabetes. If prescribed with reasonable caution psychoses, compression frac­ tures, rounded facies, buffalo hump, hirsutism, and high blood pressure usually can be avoided. It has been shown that these drugs can be given un­ interruptedly for long periods with reasonable safety. The original recommendation of starting with 300, 200 and 100 mg. of cortisone a day has been modified. Most physicians start now with 100 mg. a day, reducing the dose as improvement occurs until a maintenance level is reached. Since cortisone is not curative but must be continued for long pe­ riods the least effective dose is desirable. It is thought by some to be better to begin with 50 mg. a day, increasing in increments of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annual Review of Medicine Annual Reviews

Diseases of the Bones and Joints

Annual Review of Medicine , Volume 6 (1) – Feb 1, 1955

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References (4)

Publisher
Annual Reviews
Copyright
Copyright 1955 Annual Reviews. All rights reserved
Subject
Review Articles
ISSN
0066-4219
eISSN
1545-326X
DOI
10.1146/annurev.me.06.020155.001331
pmid
14377348
Publisher site
See Article on Publisher Site

Abstract

By ROBERT M. STECHER Department of Medicine, Western Reserve University; School of Medicine at City Hospital, Cleveland Ohio CORTISONE AND ACTH2 Any discussion of rheumatoid arthritis always brings up for consideration cortisone and its derivatives. After nearly six years of experience the drug is recognized as a substance with effective therapeutic activities as well as a potent agent for control of pain. Despite all the dire promises formerly made, cortisone properly used does not ablate adrenal activity or produce complete diabetes. If prescribed with reasonable caution psychoses, compression frac­ tures, rounded facies, buffalo hump, hirsutism, and high blood pressure usually can be avoided. It has been shown that these drugs can be given un­ interruptedly for long periods with reasonable safety. The original recommendation of starting with 300, 200 and 100 mg. of cortisone a day has been modified. Most physicians start now with 100 mg. a day, reducing the dose as improvement occurs until a maintenance level is reached. Since cortisone is not curative but must be continued for long pe­ riods the least effective dose is desirable. It is thought by some to be better to begin with 50 mg. a day, increasing in increments of

Journal

Annual Review of MedicineAnnual Reviews

Published: Feb 1, 1955

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