{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:32:52Z","timestamp":1699403572139},"reference-count":25,"publisher":"American Society of Consultant Pharmacists","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["sr care pharm"],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold>To report a case of adrenal insufficiency caused by chronic corticosteroid treatment.<jats:bold>Summary:<\/jats:bold>This case study describes a 71-year-old Caucasian woman diagnosed with secondary adrenal insufficiency (SAI). She had a long history of multiple medical problems that affected her quality of life. The pharmacist reviewed 18 years (2001-2018) of medical records, including her corticosteroid usage history. The patient had been receiving chronic medium-high dose inhaled corticosteroids for asthma, with intermittent oral prednisone for exacerbations. The pharmacist suspected a possible SAI or tertiary adrenal insufficiency (TAI) caused by hypothalamic pituitary adrenal axis suppression induced by chronic corticosteroid use. After discussions with the patient\u2019s primary care physician and a screening adrenal function test, the patient was referred to an endocrinologist, and the diagnosis was confirmed. Low-dose hydrocortisone (&lt;30 mg daily) was prescribed; the patient had improvements in mood, skin hyperpigmentation, and asthma symptoms, which eliminated the routine visits to the emergency room\/ clinic during the winter season.<jats:bold>Conclusion:<\/jats:bold>The case illustrated the benefits of utilizing a pharmacist\u2019s expertise. A consultant pharmacist can identify an underdiagnosed and rare condition, corticosteroid-induced adrenal insufficiency, through comprehensive medication review in a community medication therapy management service setting.<\/jats:p>","DOI":"10.4140\/tcp.n.2021.22","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T15:40:36Z","timestamp":1629301236000},"page":"22-33","source":"Crossref","is-referenced-by-count":1,"title":["Adrenal Insufficiency Caused by Chronic Corticosteroid Use, Identified through Medication Therapy Management"],"prefix":"10.4140","volume":"36","author":[{"given":"Tsuhua","family":"Susan Chen","sequence":"first","affiliation":[{"name":"1President and Clinical Pharmacist, Medication Therapy Management Inc. P.C., Excelsior, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shilun","family":"David Li","sequence":"additional","affiliation":[{"name":"2President Endo Micro Technology, Excelsior, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2625","reference":[{"key":"ref1","article-title":"Adrenal Insufficiency Chapter 31.","year":"2018"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/1710-1492-7-13","article-title":"Adrenal suppression: a practical guide to the screening and management of this under-recognized complication of inhaled corticosteroid therapy.","volume":"7","year":"2011","journal-title":"Allergy, Asthma & Clinical Immunology."},{"key":"ref3","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1258\/acb.2009.009101","article-title":"The diagnosis and investigation of adrenal insufficiency in adults.","volume":":46","year":"2009","journal-title":"Ann Clin Biochem."},{"key":"ref4","article-title":"Secondary Adrenal Insufficiency. 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