Clicking moves left

Enhanced Elimination in Toxicology

Enhanced Elimination in Toxicology Extracorporeal eliminationExtracorpore [...]

Decontamination in Toxicology

Decontamination in ToxicologyorHow to Decontamination in ToxicologySingle-dose [...]

Resuscitation in Toxicology

Resuscitation in ToxicologySupportive careInitial resuscitation should be based [...]

Key investigations of Toxicology

Key investigations of Toxicology In this topic: Electrocardiography Drug conce [...]

Arterial blood gases in Toxicology

Arterial blood gases in Toxicology Arterial blood gases are an important in [...]

Clicking moves right
M O V I E
TRAVELING
Pharmacology of Disopyramide
31 Mar 2012 0 comments

Pharmacology of Disopyramide Indication For the treatment of documented ventricular arrhythmias, such as [...]

Pharmacology of Ranolazine
31 Mar 2012 0 comments

Pharmacology of Ranolazine Indication For the treatment of chronic angina. It should be used in combinati [...]

Pharmacology of Milrinone
31 Mar 2012 0 comments

Pharmacology of Milrinone Indication Indicated for the treatment of congestive heart failure. Pharma [...]

Pharmacology of Midodrine
31 Mar 2012 0 comments

Pharmacology of Midodrine   Indication For the treatment of symptomatic orthostatic hypotension [...]

Pharmacology of Dofetilide
31 Mar 2012 0 comments

Pharmacology of Dofetilide  Indication For the maintenance of normal sinus rhythm (delay in time to [...]

GALLERY
Classification of Anxiety Disorders
10 Mar 2012 0 comments

Anxiety disorders may be classified asgeneralized anxiety disorder, panic disorder, obsessive-compu [...]

Post-Traumatic Stress Disorder
10 Mar 2012 0 comments

Post-Traumatic Stress DisorderPost-traumatic stress disorder develops following a traumatic event that elicit [...]

Social Anxiety Disorder
10 Mar 2012 0 comments

Social Anxiety DisorderSocial anxiety disorder, formerly known as social phobia, is characterized by an inten [...]

TOP LINE
Classification of Anxiety Disorders
10 Mar 2012 0 comments

Anxiety disorders may be classified asgeneralized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, post-traumatic stress disorder. Click to view each type....

Post-Traumatic Stress Disorder
Social Anxiety Disorder
Obsessive-Compulsive Disorder
Panic Disorder
Generalized Anxiety Disorder
REVIEW
Hormonal contraceptives
25 Apr 2011 0 comments

Hormonal contraceptivesHormonal contraceptives inhibit ovulation. Contraceptives typically contain a combination of hormones. Fo...

Erectile dysfunction therapy drugs

Erectile dysfunction therapy drugsErectile dysfunction therapy drugs treat penile erectile dysfunction that results from a lack ...

Urinary tract antispasmodics

Urinary tract antispasmodicsUrinary tract antispasmodics help decrease urinary tract muscle spasms. They include darifenacin, fl...

ANALYSIS
Pharmacology of Disopyramide
31 Mar 2012 0 comments

Pharmacology of Disopyramide Indication For the treatment of documented ventricular arrhythmias, such as sustained ventricul...

Pharmacology of Ranolazine

Pharmacology of Ranolazine Indication For the treatment of chronic angina. It should be used in combination with amlodipine, ...

Pharmacology of Milrinone

Pharmacology of Milrinone Indication Indicated for the treatment of congestive heart failure. Pharmacodynamics Milri...

HIGHLIGHT
[ more from label ]
Classification of Anxiety Disorders
Post-Traumatic Stress Disorder
Social Anxiety Disorder
Obsessive-Compulsive Disorder
Latest News Updates
PERFORMANCE
Pharmacology of Disopyramide
31 Mar 2012 0 comments

Pharmacology of Disopyramide Indication For the treatment of documented ventricular arrhythmias, such as ...

Pharmacology of Ranolazine
Pharmacology of Milrinone
FEATURE
Classification of Anxiety Disorders
10 Mar 2012 0 comments

Anxiety disorders may be classified asgeneralized anxiety disorder, panic disorder, obsessive-compu...

Post-Traumatic Stress Disorder
Social Anxiety Disorder
Home » , , , » Adverse effects of corticosteroids
Adverse effects of corticosteroids
Wednesday, November 2, 2011 Posted by Piscean


Introduction
Systemic corticosteroid treatment inevitably results in adverse effects if the dose and/or duration of treatment are sufficient, because most are dose-related biological effects of the hormone. A summary of the major adverse effects of systemic corticosteroid treatment is given in Table 6.1. More information about some of these effects and strategies for minimising them are discussed below.

Corticosteroids injected into joints or soft tissues are commonly associated with mild, transient adverse effects 

Corticosteroids applied topically can also cause adverse effects 
Important complications of corticosteroids (Table 6.1)
Glucocorticoid Mineralocorticoid
avascular necrosis of the femoral and humeral head
dermatological effects (eg skin atrophy, purpura and ecchymoses, striae, hirsutism)
gastrointestinal effects (eg dyspepsia, risk factor for peptic ulceration, gastrointestinal bleeding)
growth retardation
immunosuppression, risk of infections
metabolic effects (eg diabetes, hypertriglyceridaemia)
myopathy
ocular effects, particularly increased intraocular pressure and cataracts
osteoporosis
pituitary-adrenal suppression 
psychological disturbances (eg euphoria, depression, paranoid psychosis)
weight gain and redistribution of fat
hypertension
hypokalaemic alkalosis
sodium-retaining effects

Avascular necrosis
Avascular or ischaemic necrosis can affect a variety of bones, but most commonly involves the proximal femur. It is an infrequent and idiosyncratic adverse effect of corticosteroid treatment, and occurs more commonly following exposure to doses in excess of 20 mg/day prednis(ol)one. The time between corticosteroid exposure and the development of avascular necrosis is variable, and can be up to many years, which makes diagnosis difficult. Both the pathogenesis and treatment of this condition remain controversial.
Avascular necrosis should be considered in the differential diagnosis of hip and groin pain especially in patients who have been on high-dose and/or long-term corticosteroids at any time.

Bone density loss
Osteoporosis is a risk for patients on continuous glucocorticoid therapy in doses greater than the equivalent of prednisolone 5 to 7.5 mg per day. The risk of osteoporosis becomes greater at higher glucocorticoid doses. Loss of bone mineral density occurs rapidly after corticosteroids are commenced and may exacerbate the osteoporosis associated with some rheumatological diseases, such as ankylosing spondylitis, and inflammatory bowel disease .

If corticosteroid therapy is expected to last for longer than a month, strategies to minimise bone density loss should begin as soon as treatment with corticosteroids starts.

The key issues are:
  • weight-bearing exercise where possible
  • adequate calcium intake
  • measurement and addition of vitamin D if indicated
  • monitoring bone densitometry from initiation of long-term glucocorticoid therapy
  • bisphosphonate therapy as indicated.
For further discussion and detail,


Hyperglycaemia
Hyperglycaemia frequently accompanies treatment with high-dose corticosteroids. While oral hypoglycaemic agents can often control this, insulin may be necessary. Regimens using intermediate-acting insulin at lunchtime may be most successful in controlling the hyperglycaemia, which is commonly worse in the evening.
Blood glucose levels should be closely monitored in diabetic patients on long-term corticosteroid therapy.
Infections

High-dose corticosteroids increase the risk of contracting many types of infection, and may mask the early symptoms of infection, resulting in later diagnosis, delay in treatment, and more severe clinical consequences. Reactivation of Mycobacterium tuberculosis (TB) infection occurs with such frequency that prior to commencing immunosuppressive treatment with corticosteroids, screening for active or latent TB should be considered . Prophylaxis for Pneumocystis jiroveci (carinii) infection should be considered in patients who are at risk and on high-dose oral corticosteroids long term 

Use of steroid-sparing drugs
Drugs from other classes may be used to allow a reduction of the corticosteroid dose. For example, in rheumatology, use of disease-modifying antirheumatic drugs (DMARDs) and NSAIDs often allows a lower corticosteroid dose to be used.

Piscean

Thanks for your visit..!

0 comments for "Adverse effects of corticosteroids"

   

Leave a reply

    March - 2025
    SMTWTFS
          1
    2345678
    9101112131415
    16171819202122
    23242526272829
    3031