Medical Care

The treatment for exogenous Cushing syndrome is gradual withdrawal of the causative drug, with the aim of discontinuing the causative drug if possible. An individual with HPA-axis suppression cannot increase steroid production appropriately during a medical illness or other stress and should receive stress-dose steroids to avoid adrenal crisis.^[7]

See Glucocorticoid Therapy and Cushing Syndrome.

Follow-up

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Media Gallery

Physical findings in Cushing syndrome.
Diagnosis of Cushing syndrome.

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Table 1. Glucocorticoid Equivalencies^[13]

Table 1. Glucocorticoid Equivalencies ^[13]

Type	Drug	Dose	Relative Glucocorticoid Potency	Relative Mineralocorticoid Potency	Plasma Half-Life (mg)	Biologic Half-Life (h)
Short-acting	Cortisol	20	1.0	2	90	8-12
Short-acting	Hydrocortisone^‡	25	0.8	2	80-118	8-12
Intermediate-acting	Prednisone	5	4	1	60	18-36
	Prednisolone	5	4	1	115-200	18-36
	Triamcinolone	4	5	0	30	18-36
	Methylprednisolone	4	5	0	180	18-36
Long-acting	Dexamethasone	0.5	25-50	0	200	36-54
Long-acting	Betamethasone	0.6	25-50	0	300	36-54
Mineralocorticoid	Aldosterone	0.3	0	300	15-20	8-12
	Fludrocortisone	2	15	150	200	18-36
	Desoxycorticosterone acetate	0	0	20	70	…

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Author

Ha Cam Thuy Nguyen, MD Fellow, Department of Endocrinology, University of Pittsburgh Medical Center

Ha Cam Thuy Nguyen, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Physicians, American Medical Association, Endocrine Society

Disclosure: Nothing to disclose.

Coauthor(s)

Catherine Anastasopoulou, MD, PhD, FACE Associate Professor of Medicine, The Steven, Daniel and Douglas Altman Chair of Endocrinology, Sidney Kimmel Medical College of Thomas Jefferson University; Einstein Endocrine Associates, Einstein Medical Center

Catherine Anastasopoulou, MD, PhD, FACE is a member of the following medical societies: American Association of Clinical Endocrinologists, American Society for Bone and Mineral Research, Endocrine Society, Philadelphia Endocrine Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Romesh Khardori, MD, PhD, FACP (Retired) Professor, Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Eastern Virginia Medical School

Romesh Khardori, MD, PhD, FACP is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Physicians, American Diabetes Association, Endocrine Society

Disclosure: Nothing to disclose.

Acknowledgements

Gail K Adler, MD, PhD, Associate Professor of Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School.

Disclosure: Nothing to disclose.

Susanna L Dipp, MD Fellow, Department of Medicine, Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School

Disclosure: Nothing to disclose

Don S Schalch, MD Professor Emeritus, Department of Internal Medicine, Division of Endocrinology, University of Wisconsin Hospitals and Clinics

Don S Schalch, MD is a member of the following medical societies: American Diabetes Association, American Federation for Medical Research, Central Society for Clinical Research, and Endocrine Society

Disclosure: Nothing to disclose