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- Опубліковано 28 вер 2024
- *in the beginning of the video at 1.14 min, there is slip of tongue, it's adrenal gland NOT kidney from where corticosteroids are secreted.
Onset of action (missed in the video)
Hydrocortisone Onset of action: IV: 1 hour.
Methylprednisolone Onset of action: IV (succinate): Within 1 hour; Intra-articular (acetate): 1 week
Dexamethasone Onset of action: IV: Rapid.
Difference between various corticosteroids in ICU specifically Hydrocortisone, Methylprednisolone, Dexamethasone
#steroids_in_icu
This above video has tried to address and explain the following things:
Why we use difference steroids in icu,
difference between Hydrocortisone Methylprednisolone Dexamethasone,
when to use which corticosteroid in icu,
glucocorticoid and mineralocorticoid activity of corticosteroid,
duration of action of different corticosteroids,
orticosteroids explained in a simple way,
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Sir, in the very beginning there seems to be a small slip of tongue on site of steroid secretion falsely uttered as 'kidney' rather than 'adrenal gland'
Oh yes, thank you for pointing out . Pinning your comment 🙏🏼🤝
Thank you sir
@@TheICUChannel sir video me cut edit krlo
Can’t edit once uploaded
Can u tell what’s wrong in it .
Hydrocortisone..... H.
High or Quick in action..
Methylprednisolone....M..medium in action.,
Dexamethasone....D. Delayed action and effects, action for Days.
If you all still have any doubt regarding this concept, do let me know in the comment. Thank you
Sir the onset of action of individual steroids need to discussed.
Why hydrocortisone is frequently used in respiratory conditions like asthma or treatment of wheeze if it has low antiinflammatory activity
Sir I have a doubt. Dexa has 25x glucocorticoid activity then hydrocort. So 4mg dexa roughly eqates to 100mg hydrocort in terms of potency. For example, if we're using 100mg TID hydrocort in patient A & 4mg TID dexa in patient B then the anti inflammatory(glucocorticoid) effect in both scenarios should be theoretically same. Of course in patient A, there's added benefit of increasing MAP but there shouldn't be adverse increased immunocompromised effect in patient B(since total equipotent dosage is still same in both patients). Isn't it sir?
One of the best lecture vedio on internet oh my god sir I just want to thank you thousands times ...love you boss
Being a Homoeopath see lot of asthma cases n need the proper knowledge of steroids which r at times life saving . But today I came to know how they help n work . Thank you v sir for giving simpler understanding n right direction.
Ur like gold to us ..I'm studied more critical care books for mechanical ventilation but with help of ur vedios I learned more than books..and this differentiation of steroid topic help us to choose which steroid depending upon the situation of patient in ICU..❤❤❤THANK YOU Sir
Thank u for your kind words and welcome to ESBICM
Which is best book for emergency medicine
May Allah bless you sir. You are doing great work for the community.
In Simple way very much information covered, thnku sir
Can upload more topic on different Drugs in using which condition
Thank you for this good and simple explanation
Thanks and welcome to ESBICM
Excellent explanation /discussion.
Glad you liked it!
very good explanation..thank you sir 😊
Sir Charan sparsh....foolo se shahad nikal kr dene ke liye!!
Excellently explained
Sir can you make similar video on different insulin preparations and their right use and maybe devices also
Very well explained.. thank you..
thanks so much
from srilanka
Thanks and welcome from India 🇮🇳
Excellent explanation! Thank you!
Glad you enjoyed it!
Hi , it was very helpful and informative , could you plz specify/comments dosages of these steroids accordingly and taper off ???
Sir make shorts, whith lots of knowledge
V nice explanation sir
Sir can you please briefly discuss the effect of SGLT2 inhibitor on RAAS system activity
Sir One session for....prevention of deep vein thrombosis in ccu patient
My doubt is hydrocortisone is used in sepsis or septic shock , because as per my training during md , my teachers used to avoid hydrocortisone in sepsis , but used to add in septic shock , got confused after seeing this video , can u please elaborate ?
#icushort 225: Steroids in sepsis or septic shock #esbicm #theicuchannel #shorts
Thanks for clearing my doubts , good job sir ,keep making such valuable videos.
Regards
Thanks, got enough knowledge.
Best. Thank you🎉
Amazing
Nice video
Excellent and brief but very thoughtful explanation…thank you sir
What about Methyl prednisolone giving in hanging patients to reduce Cord edema ; why not Dexamethasone ?
Thank you so much sir.
Nice
Sir great respect for you! Wish to be on rounds with you!!
What is the specific reason for methylprednisolone to be relatively more expensive??
Beyond my understanding.
Thank you sir
Thank u so much sir 😊
Sir I have seen some anesthesiologist give iv dexa in case of severe rigors in OT , what is logic behind it sir?
Sir do add about deflazacort...not much authentic literature avaiable about deflazacort
Nice content❤
Thanku Sir
Sir I want to ask you which steroid is better in pulmonary oedema with pleural effusion
Thanku you sir 🙏
Thank you 🎉
You’re welcome 😊
Sir how to manage secretions in intubated patients
Dose frequency of dexa and other steroid
Thank you sir so much
Most welcome
sir what would be the preferable corticosteroid if a patient comes with pneumonic sepsis, and h/o high blood sugar and hypertension?
Hydrocortisone
Sir, is it safe to give a patient corticosteroids for HLH disease during septic shock?
Kindly reply
See this is an educational channel not a medical advice channel . We have answered your question above and for more clarification, connect with your medical team.
Ok sir
Thank u sir…may i know which book u r referring in this video sir
Lippincot pharmacology
Inj dexa use in lB/L Lungs cracales lower lobes??
Sir in Anaphylaxis condition which steroid is best
Sir..i think you had slip of toungue in the beginning. Corticosteroids are secreted by adrenals sitting over both the kidneys.
Yes , already mentioned in the description and pinned the first comment for this.
@@TheICUChannel sorry.. didn't notice
@@alwintony7020 not an issue, glad u noticed 👍🏼
how to taper the dose of steroids
Depends on duration of use and condition .
Sir plz reference....book??
I was reading lippincot pharmacology
Sir what about the use of kenacort
we don't use it IV.... not even in ICU. I think its only used a topical.
Deflazacort??
Steroids are secreted from adrenal glands 😂😂😂😂😂
That was a slip of tounge, which is corrected on description and the first pinned comment of the video .
need your number sir
Sir doing God's work. I work in a icu and I have learnt so much from him.
Sir please make an explanation of the sedatives used in a ventilated patient
Thank you so much sir 🙏
Query - Although different corticosteroids have different potency, but their dosages are also different e.g Hydrocortisone usually given 100-200mg per dose but Dexa given 6-8 mg per dose(i.e higher potency but lower dose) .So the difference in potency doesn't seem to be a factor for choosing the type of corticosteroid as the difference in potency is balanced out by lowering of dosage.
Yes true it’s balanced , still the effect is more is adjusted doses if u see the table and also predominant effect also plays a role in it . See the indications of corticosteroids table and analyse the pattern in which they are given .
Superb sir. In Pediatrics MP is mainly used in Neurology conditions viz. Autoimmune Encephalitis, MS, NMO Spectrum, MISC. Yes Dexa is same as you highlighted.
Very informative for Residents and Young Intensivist.
Great video sir can you also make a similar video explaining how to upgrade and downgrade antibiotics and what antibiotics to choose in various gram +ve and gram -ve bacterial infection/sepsis in ICU setting.
Sir, wonderful explanation. What a selfless professional !
Thank you for this lecture. May I suggest some questions/topics?
- Fluid and electrolyte balance
- Thromboprophylaxis
- How to know when to step up or down on treatment in terms of antibiotics, ventilator settings, diuretics, etc.
Finally, some case studies of important ICU cases, starting from when patient is brought to ICU, all the way til patient can be shifted out, where we can follow along the treatment, and understand how to manage new issues, stepping down/up treatment and specific treatment of the main condition.
Thank you so much for these lectures, really appreciate your work, watching from outside India.
These are very basics. Please get into ICU Fellowship for 1 year you will get all the answers.
@@BLUEBIRDclinic there are so many institutes providing fellowships and isccm is also providing ctccm for 2 years
@@BLUEBIRDclinic Any Corporate Hospital Fellowship. No need of college.
@@BLUEBIRDclinic MD, DNB(PAEDS), MNAMS itna he kaafi hai.
@@BLUEBIRDclinic Get MD Anaesthesia anywhere. It's very easy to get. You will become an Intensivist. After MBBS there is no scope of becoming an Intensivist.
keep doing this good job of educating (creating more Doctors) Dr.
I was sitting in a bus on way to hospital. And i open this video thanks alot sir... ❤️❤️❤️❤️
Clean crispy talk....hats off
sir....Kindly make a video on Management of weaning failure after prolonged ventilation sir..&..role of Respiratory Stimulants in it....!!
Sir grow a beard and become professor from Money Heist I can see similarities 😂
Sir . Which is the best I v fluid used for paeds in cardiac ICU?
Sir all steroids cross blood brain barrier or only dexamethazone?
Sir does speed of onset of action also plays a role in choosing steroid
If dexa is more potent anti infl than Hydrocortisone, why do we use Hydrocortisone / mps in acute severe asthma
They have rapid onset of action
Sir, can u please make videos about how to prepare for EDIC exam & what books & what are the topics to study??
Soon , it’s next on list .
Very informative ❤
Thanks for explaining in simple and best possible words
I'm learning a lot from your lectures 🙏
which one to use in pulmonary edema?
Great info, thank you.
Sir how to switch one steroids to another
Love and respect from Afghanistan ❤
thanks for your joining and ur support... lots of wishes from India.
Very informative
Sir in CRF leading to Pulm Edema, dexamethasone will be used?
No
Please provide honestly...What are the side effects of Solu Medrol (IV) taken for 2 days... and Depa Medrol (IM) Taken for 1 day.... taken for the treatment of tinnitus...
if you are a health care professional, u know that such short period usually don't have any side effect.
Really helpful..and very precise.. thanks alot......wud really appreciate videos on managing emergencies ,Ike dka,hhs, hyponatremia, substance abuse cases
Thanks alot sir..
Superb. Each word is full of information.
Glad you liked it
What to use for allergic reaction due to any insect bite or plant ,should we use dexa or hydrocortisone.
dexamethasone theoretically. but previous algorithm uses hydrocortisone. now they are 2nd-3rd line. adrenaline is the first choice.
Can we give anticoagulation in patients who have Intracranial bleed and Venous Thrombosis simultaneously
How to give methylprednisolone either in dilution and in how much dilution
STERIODS(MOTHER OF ALL DRUGS)
Duration of action
1.Short acting (1-12hrs)=Hydrocortisone
2.Intermittent acting(12-36hrs)=Methylprednisolone
3.Long acting(36-55hrs)=Dexamethasone
Hello sir what about deflzacort ....????and sir which steroids in organ transplant..????
In autoimmune disorder like in lupus nephritis or in others we use solomedrol rather I think we should use dexa???
❤Sir a cordiall wellwish from Srinagar ,classic comprehensive work ,I hope this will continue ,may god bless you.Requesting for management of hypertensive emergencies.
Sir ,that was a very usefull class. Can u take same type of class for hypocalcaemia management. ? Like when to give 10% over 10mins , 2gm in 100ml ns ,6gm in 5%dns for 24hrs ... Hope I'm right ?
Thank you sir. Thank you very much.. very much needed.. love from Pakistan ❤❤
Thank you doctor...Very nice explanation...you are the god of this topic...Thank you so much
Hi sir ive doubt . Actually in my ER duty one patient came with headache since 2 days and he was slightly confused. He had h/0 fever on and off since 1 month. Ct brain suggestive of right temperoparietal edema with mild mid line shift. Patient was not cooperative for mri hence we referred. So our neurologist suggested to give methyl prednisone over dexa.. she told dexa is of no use in this condition. Can you pls explain sir. Waiting for yr reply. Thank you sir
Sir, my father was given corticosteroids for HLH disease during septic shock. Was it safe during septic shock?
Yes, Its indicated in refractory septic shock,
Ok sir
Thank you sir
So nice of you
Dr thanks for the vedio
I have doubt regarding methylpred normal dosing and pulse therapy high dosing , significance.
🫡 salute to you. Very simple, concisely to the point and very comprehensible. Thanks for clearing our concepts.