Tapering Oral Steroids
                        ======================

þ Tapering Steroids for Pharmacologic Effect
 - Usually not needed.

þ Tapering steroids because of possible adrenal axis suppression
 - not needed if less than 2 weeks of therapy.  Even patients with adrenal
   axis suppression documented by standard endocrinologic testing, those
   patients were able to undergo the stress of surgery without supplemental
   steroids. [Truhan AP, Ahmed AR.  Corticosteeroids:  a review with emphasis
   on complications of prolonged systemic therapy.  Ann Allergy
   1989;62(5):375-391.]  [Iafrate RP, Massey KL, Hendeles L.  Current oncepts in clinical
   therapeutics:  asthma.  Clin Pharm 1986; 5(3):206-227.]
 - administering dose in the the AM, along with normal cortisol peak, helps
   minimize adrenal axis suppression.
 - some people may develop withdrawal syndrome after stopping steroids without
   evidence of adrenal axis suppression:  malaise, nausea, mualgia, low-grade
   fever, and headache.  _No_ correlation with adrenal axis suppression.
   [Truhan article, above, page 382.]