Steroid Safety Review: Receptors, Replacement and Sick Days | Part 2 | 用藥 | OET Music

Dr Allison Lu · Pip & Barnaby · Medical English

本頁提供本曲完整英文歌詞與影片搭配的繁中醫學提示。歌詞保留原演唱文字;遇到過度簡化或舊門檻,請搭配下方提示與原始資料閱讀。這是概念學習材料,不替代個別醫療評估。

Lyrics · 完整歌詞

Selective oestrogen receptor modulators differ by tissue:
clomiphene blocks hypothalamic receptors to raise gonadotrophins,
tamoxifen antagonises the breast but stimulates the endometrium,
and raloxifene spares the uterus.
Growth hormone deficiency receives somatropin, Laron syndrome receives IGF-1,
and acromegaly receives octreotide, never growth hormone.

All long-term glucocorticoid courses suppress ACTH,
so they are tapered slowly and doubled on sick days.
Is the potassium normal and the skin unpigmented?
Then the insufficiency is secondary, because aldosterone still answers to renin.
On suspicion of adrenal crisis,
hydrocortisone 100 mg intravenously precedes the cortisol result,
followed by 200 mg over twenty-four hours.
Lumbar bone density falls fastest on glucocorticoids,
so alendronate reduces resorption while intermittent teriparatide alone builds bone.


All long-term glucocorticoid courses suppress ACTH,
so they are tapered slowly and doubled on sick days.
Is the potassium normal and the skin unpigmented?
Then the insufficiency is secondary, because aldosterone still answers to renin.
On suspicion of adrenal crisis,
hydrocortisone 100 mg intravenously precedes the cortisol result,
followed by 200 mg over twenty-four hours.
Lumbar bone density falls fastest on glucocorticoids,
so alendronate reduces resorption while intermittent teriparatide alone builds bone.

Medical Notes · 醫學學習提示

  1. 選擇性雌激素受體調節劑,作用因組織而異
  2. Clomiphene 阻斷負回饋,增加促性腺激素分泌
  3. Tamoxifen 抗乳房雌激素作用,但可刺激子宮內膜
  4. Raloxifene 未顯示增加內膜癌風險;仍須評估血栓風險
  5. 確診 GH 缺乏可補充;Laron 嚴重 IGF-1 缺乏由專科治療
  6. 活動性肢端肥大不補 GH;多數先評估手術,藥物依病況選擇
  7. 長期糖皮質素有抑制風險,程度因劑量與個人而異
  8. 減量與病假日加量依個別計畫;持續嘔吐須注射救援並急診
  9. 血鉀正常、無色素沉著,只是鑑別線索
  10. 不能單憑兩項確診中樞性不足;醛固酮通常保留
  11. 懷疑腎上腺危象,立即急救,不等檢驗結果
  12. 成人氫化可體松 100 mg 靜脈或肌注,並補充液體
  13. 續以 200 mg/24 小時;補液依循環與心腎狀況調整
  14. 類固醇使骨質快速流失,腰椎等骨小樑部位易受影響
  15. Alendronate 抑制骨吸收;造骨藥不只 teriparatide

References