Which patient should not start hydrocortisone therapy?

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Hydrocortisone therapy is often utilized in various clinical situations, particularly when addressing inflammatory or autoimmune conditions. However, in the context of sepsis, the decision to initiate glucocorticoid therapy can vary based on a patient's specific condition and the presence of other factors.

In patients with sepsis, there is a risk that administering glucocorticoids, such as hydrocortisone, could potentially suppress the immune response and interfere with the body's natural ability to combat infection. Though there are instances in which hydrocortisone may be indicated in severe sepsis or septic shock to help manage the inflammatory response, it is crucial to evaluate each case carefully. The timing, dosage, and overall clinical picture will significantly influence the decision to start therapy. Thus, a patient with sepsis may require cautious consideration before starting hydrocortisone, making it a situation where therapy should not be initiated without careful assessment.

In contrast, patients with asthma, chronic obstructive pulmonary disease, or neuromuscular diseases generally wouldn't have the same immediate concerns regarding hydrocortisone therapy in the way that a patient with sepsis would. For these conditions, hydrocortisone could be beneficial to manage inflammation or other associated symptoms.

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