Glucocorticosteriod Replacement Guidelines
History of systemic use of more than 7.5 mg/day of prednisone for
more than 3 weeks.
|Presently using more than
7.5 mg/day of systemic prednisone.
|Glucocorticosteroid use on alternating days.|
|Minimally stressful procedures||If within 2 weeks after cessation of glucocorticosteroid therapy: Give previous maintenance dose on morning of appointment.||No supplementation of glucocorticosteroids needed.||No supplementation of glucocorticosteroids needed. Provide dental care on same day patient is taking glucocorticosteroids.|
|Stressful procedures||If within 3 weeks after cessation of glucocorticosteroid therapy: Give previous maintenance dose on morning of appointment.||Double daily dose on day of procedure and give an additional single dose on first postoperative day if pain is anticipated.||Double daily dose and provide dental care on same day patient is taking glucocorticoteroids.|
Always monitor blood pressure during the procedure.
Always prevent any intraoperative pain.
Always provide postoperative analgesia.