Which corticosteroid has the longest biological half-life, making it most suitable for alternate-day therapy to minimize HPA axis suppression?

• A Hydrocortisone (cortisol)
• B Dexamethasone
• C Prednisolone ✓
• D Triamcinolone

Explanation

The question asks which corticosteroid is most suitable for alternate-day therapy. Dexamethasone has the longest biological half-life (36-72 hours) but is NOT suitable for alternate-day therapy because its prolonged action causes sustained HPA suppression. Prednisolone (intermediate duration, 12-36 hours) is the preferred agent for alternate-day therapy, as the HPA axis recovers on the off day. Hydrocortisone is too short-acting. Triamcinolone is intermediate but prednisolone is the standard choice for alternate-day regimens. The discriminating fact is that long duration precludes alternate-day use.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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