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Data on MTX support the use of intramuscular MTX in Crohn disease, but such data are lacking in ulcerative colitis. The only trial of MTX in ulcerative colitis used a low-dose oral therapy [ 93 ] ; whether a higher-dose oral MTX or parenteral MTX (IM or SQ) may be effective in ulcerative colitis has not been studied. Several clinical trials showed that AZA continuation in patients with ulcerative colitis prevented relapse, as compared to those who discontinued the medication. However, other trials have shown trends but no statistically significant benefit of AZA in ulcerative colitis. [ 94 ]

Thyroid storm is a life-threatening condition of the hyperthyroid state. 26 It most commonly occurs in patients with Graves' disease but may also occur in those with multinodular goiter or toxic adenoma. 27 It is treated by correcting the hyperthyroidism and treating the precipitating events. 26 Correction of the hyperthyroid state involves using drugs such as propylthiouracil or methimazole (Tapazole), beta blockers or corticosteroids, which decrease the peripheral effects of thyroid hormone and the conversion of thyroxine (T 4 ) to the more potent triiodothyronine (T 3 ). 22 , 26 Dexamethasone can be used for that purpose, at a dosage of 2 mg intravenously every six hours, and can eventually can be switched to an oral dosage of 2 mg every six hours. 28

Tapering iv steroids

tapering iv steroids

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