Module 4 - glucocorticoids

Question 1

How do glucocorticoids differ in their molecular mechanism of action from most drugs?

Answer 1

Glucocorticoids differ in two ways: their receptors are located inside the cell rather than on the cell surface, and they modulate the production of regulatory proteins rather than affecting signaling pathways.

Question 2

What happens when glucocorticoids penetrate the cell membrane and bind with receptors in the cytoplasm?

Answer 2

When glucocorticoids bind with receptors in the cytoplasm, they convert the receptor from an inactive form to an active form.

Question 3

What is the next step in the molecular mechanism of glucocorticoids after the receptor becomes active in the cytoplasm?

Answer 3

After becoming active in the cytoplasm, the receptor-steroid complex migrates to the cell nucleus.

Question 4

What does the receptor-steroid complex do in the cell nucleus?

Answer 4

In the cell nucleus, the receptor-steroid complex binds to chromatin in DNA, which alters the activity of target genes.

Question 5

In most cases, how do glucocorticoids affect the activity of target genes?

Answer 5

In most cases, glucocorticoids increase the activity of target genes, leading to increased transcription of messenger RNA molecules for specific regulatory proteins.

Question 6

Are there situations where glucocorticoids suppress the activity of target genes, and if so, what is the outcome?

Answer 6

Yes, in some cases, glucocorticoids suppress the activity of the target gene, leading to decreased synthesis of certain regulatory proteins.

Question 7

How do glucocorticoids differ in their molecular mechanism of action from most drugs?

Answer 7

Glucocorticoids differ in two ways: their receptors are located inside the cell rather than on the cell surface, and they modulate the production of regulatory proteins rather than affecting signaling pathways.

Question 8

What happens when glucocorticoids penetrate the cell membrane and bind with receptors in the cytoplasm?

Answer 8

When glucocorticoids bind with receptors in the cytoplasm, they convert the receptor from an inactive form to an active form.

Question 9

What is the next step in the molecular mechanism of glucocorticoids after the receptor becomes active in the cytoplasm?

Answer 9

After becoming active in the cytoplasm, the receptor-steroid complex migrates to the cell nucleus.

Question 10

What are the pharmacologic effects of glucocorticoids when administered in high doses for nonendocrine disorders?

Answer 10

High doses of glucocorticoids produce anti-inflammatory and immunosuppressive effects that are not seen at physiologic doses.

Question 11

Are there any physiologic effects associated with high-dose glucocorticoid administration?

Answer 11

Yes, in addition to their pharmacologic effects, high doses of glucocorticoids also produce the physiologic effects observed at low doses.

Question 12

What are the metabolic effects of high-dose glucocorticoid therapy compared to physiologic doses?

Answer 12

High-dose glucocorticoid therapy intensifies metabolic effects, including elevated glucose levels, suppressed protein synthesis, and increased mobilization of fat deposits.

Question 13

Do most glucocorticoids have significant mineralocorticoid activity?

Answer 13

No, most glucocorticoids have very little mineralocorticoid activity, which generally results in limited sodium retention and potassium loss.

Question 14

Is sodium retention and potassium loss completely absent with high-dose glucocorticoid therapy?

Answer 14

No, although most glucocorticoids have minimal mineralocorticoid activity, sodium retention and potassium loss can still occur in some patients and may pose risks.

Question 15

What effect does high-dose glucocorticoid therapy have on the intestinal absorption of calcium?

Answer 15

High-dose glucocorticoid therapy can inhibit the intestinal absorption of calcium, an effect not observed at physiologic doses.

Question 16

What are the major clinical applications of glucocorticoids primarily related to?

Answer 16

The major clinical applications of glucocorticoids stem from their ability to suppress immune responses and inflammation.

Question 17

What are the characteristic symptoms of inflammation, and what initiates them?

Answer 17

The characteristic symptoms of inflammation are pain, swelling, redness, and warmth, initiated by chemical mediators such as prostaglandins, histamine, and leukotrienes.

Question 18

How do prostaglandins and histamine contribute to inflammation symptoms, particularly pain and swelling?

Answer 18

Prostaglandins and histamine promote inflammation symptoms by causing vasodilation and increasing capillary permeability. They contribute to pain, with histamine directly stimulating pain receptors, and prostaglandins sensitizing pain receptors.

Question 19

How do neutrophils and macrophages intensify inflammation, and what damage can they cause?

Answer 19

Neutrophils and macrophages heighten inflammation by releasing lysosomal enzymes that cause tissue injury.

Question 20

What role do lymphocytes play in amplifying inflammation, and how do they do it?

Answer 20

Lymphocytes, crucial elements of the immune system, amplify inflammation by causing direct cell injury and promoting antibody formation, which helps perpetuate the inflammatory response.

Question 21

What are the mechanisms through which glucocorticoids interrupt the inflammatory process?

Answer 21

Glucocorticoids interrupt inflammation through multiple mechanisms, including the inhibition of chemical mediator synthesis, suppression of phagocyte infiltration, and reduction of lymphocyte proliferation.

Question 22

How do the mechanisms by which glucocorticoids suppress inflammation compare to those of nonsteroidal anti-inflammatory drugs (NSAIDs)?

Answer 22

The mechanisms by which glucocorticoids suppress inflammation are more diverse than those of NSAIDs, which primarily inhibit prostaglandin production. Glucocorticoids act through multiple pathways, resulting in more potent anti-inflammatory effects.

Question 23

For what purpose are glucocorticoids indicated in rheumatoid arthritis?

Answer 23

Glucocorticoids are indicated for adjunctive treatment of acute exacerbations of rheumatoid arthritis.

Question 24

What is the primary effect of glucocorticoids in rheumatoid arthritis?

Answer 24

Glucocorticoids can reduce inflammation and pain but do not alter the course of the disease.

Question 25

Why is prolonged systemic use of glucocorticoids in rheumatoid arthritis generally avoided?

Answer 25

Prolonged systemic use of glucocorticoids is avoided due to the risk of serious complications.

Question 26

Under what circumstances may intra-articular injections of glucocorticoids be advantageous in rheumatoid arthritis?

Answer 26

Intra-articular injections may be advantageous when arthritis affects only a few joints.

Question 27

What are the advantages of using local injections of glucocorticoids in rheumatoid arthritis?

Answer 27

Local injections can be highly effective and have less toxicity compared to systemic therapy.

Question 28

What can be the result of intra-articular injections of glucocorticoids in terms of pain and joint mobility?

Answer 28

Intra-articular injections can lead to significant reductions in pain and inflammation and may prompt increased joint mobility.

Question 29

What precaution should be given to patients who have received intra-articular glucocorticoid injections for rheumatoid arthritis?

Answer 29

Patients should be cautioned against excessive use of the treated joints, even if their symptoms have improved.

Question 30

What concern is associated with the long-term use of glucocorticoids in children?

Answer 30

Long-term use of glucocorticoids in children can inhibit bone growth and potentially result in decreased stature.

Question 31

How does glucocorticoid use during periods of increased bone growth in children affect the risk of osteoporosis?

Answer 31

Glucocorticoid use during periods of increased bone growth increases the risk of lifetime osteoporosis.

Question 32

What are the patient care concerns regarding the use of glucocorticoids in pregnant women?

Answer 32

Inadequate studies in pregnant women.
Teratogenic and physiologic effects observed in animal studies.
Possible contribution to cleft palate if used during the first trimester.
Risk of neonatal hypoadrenalism if used later in pregnancy.
Benefits versus risks assessment needed.
Smallest effective dose and non-systemic formulations preferred.
Hydrocortisone preferred for systemic use.

Question 33

What advice is given regarding breastfeeding for women taking glucocorticoids?

Answer 33

Low doses likely have minimal impact on nursing infants.
High pharmacologic doses can lead to growth delay and adverse effects in nursing infants.
Breastfeeding is not recommended for women taking high doses of glucocorticoids.

Question 34

What concerns may affect older adults who use glucocorticoids long-term?

Answer 34

Long-term glucocorticoid use in older adults can lead to osteoporosis, adrenal insufficiency, and gastrointestinal (GI) ulceration, which may affect them disproportionately.

Question 35

What type of doses of glucocorticoids are associated with adverse effects?

Answer 35

Adverse effects of glucocorticoids occur in response to pharmacologic doses, not physiologic doses.

Question 36

How does the intensity of adverse effects change with dosage size and treatment duration?

Answer 36

The intensity of adverse effects increases with higher doses and longer treatment duration of glucocorticoids.

Question 37

Are most adverse effects of glucocorticoids observed when treatment is brief (a few days or less)?

Answer 37

No, most adverse effects are not observed when treatment is brief, even at high doses of glucocorticoids.

Question 38

What is a common and serious complication of prolonged systemic glucocorticoid therapy?

Answer 38

Osteoporosis with fractures is a common and serious complication of prolonged systemic glucocorticoid therapy.

Question 39

Is osteoporosis a common complication when glucocorticoids are administered via inhalation or topically?

Answer 39

No, it is uncommon when glucocorticoids are inhaled or administered topically, even with prolonged use.

Question 40

Which bones are most affected by glucocorticoid-induced osteoporosis?

Answer 40

The ribs and vertebrae are the bones most affected by glucocorticoid-induced osteoporosis.

Question 41

How soon can vertebral compression fractures occur in some patients on high-dose glucocorticoids?

Answer 41

In some cases, vertebral compression fractures can occur within weeks of starting glucocorticoid therapy.

Question 42

What should patients on glucocorticoid therapy be observed for in relation to osteoporosis?

Answer 42

Patients should be observed for signs of compression fractures, such as back and neck pain, and indications of fractures in other bones.

Question 43

What are the three primary causes of glucocorticoid-induced osteoporosis?

Answer 43

The three primary causes are suppression of bone formation by osteoblasts, acceleration of bone resorption by osteoclasts, and reduced intestinal calcium absorption leading to hypocalcemia and increased parathyroid hormone release.

Question 44

How do glucocorticoids affect susceptibility to infection?

Answer 44

Glucocorticoids can increase susceptibility to infection by suppressing host defenses.

Question 45

What risks are associated with glucocorticoid use in relation to infections?

Answer 45

Increased risk of acquiring new infections.
Risk of reactivating latent infections, such as tuberculosis.
Potential for masking infection symptoms, leading to fulminant infections.

Question 46

What is the role of the inflammatory response in wound healing?

Answer 46

The inflammatory response plays a prominent role in wound healing.

Question 47

How can glucocorticoid therapy affect wound healing?

Answer 47

Glucocorticoid therapy interferes with normal inflammatory responses and can impair and delay wound healing.

Question 48

What effect can glucocorticoids have on plasma glucose levels?

Answer 48

Glucocorticoids can increase plasma glucose levels, leading to hyperglycemia and glycosuria.

Question 49

What is myopathy, and how is it related to high-dose glucocorticoid therapy?

Answer 49

Myopathy is characterized by weakness, and high-dose glucocorticoid therapy can cause it. Proximal muscles of the arms and legs are most affected, and severe damage can inhibit ambulation.

Question 50

Why can glucocorticoids cause fluid and electrolyte disturbances?

Answer 50

Due to their mineralocorticoid activity, glucocorticoids can cause sodium and water retention and potassium loss, potentially leading to hypertension, edema, dysrhythmias, and digitalis toxicity.

Question 51

Is serious fluid and electrolyte disturbance common with most glucocorticoids in current use?

Answer 51

No, most glucocorticoids in current use have minimal mineralocorticoid activity, reducing the risk of serious fluid and electrolyte disturbances.

Question 52

How do glucocorticoids affect growth in children, and why does growth delay occur?

Answer 52

Glucocorticoids can suppress growth in children, likely due to reduced DNA synthesis and decreased cell division.

Question 53

What psychologic disturbances can systemic glucocorticoids cause, and what percentage of patients experience them?

Answer 53

Systemic glucocorticoids can cause mild reactions like insomnia, anxiety, agitation, or irritability in about 60% of patients. Approximately 6% experience severe reactions, including delirium, hallucinations, depression, euphoria, or mania, and some may become suicidal, with up to one-third experiencing this outcome.

Question 54

Does a history of previous psychiatric illness predispose patients to psychologic reactions caused by glucocorticoids?

Answer 54

No, previous psychiatric illness does not seem to predispose patients to psychologic reactions caused by glucocorticoids, and a history of good mental health does not provide protection.

Question 55

What ocular complications can result from long-term glucocorticoid therapy?

Answer 55

Cataracts and open-angle glaucoma are common complications of long-term glucocorticoid therapy.

Question 56

What factors may contribute to the development of cataracts in individuals receiving glucocorticoid therapy?

Answer 56

The development of cataracts may be related to factors such as age, dosage, or individual susceptibility in those receiving glucocorticoid therapy.

Question 57

How can glucocorticoids predispose individuals to peptic ulcer disease, and what additional factors increase the risk of ulceration?

Answer 57

Glucocorticoids can predispose individuals to peptic ulcer disease by inhibiting prostaglandin synthesis, augmenting gastric acid and pepsin secretion, inhibiting mucus production, and reducing gastric mucosal blood flow. The risk for ulceration is increased by concurrent use of other ulcerogenic drugs, such as aspirin and NSAIDs.

Question 58

What is iatrogenic Cushing syndrome, and what are its prominent symptoms?

Answer 58

Iatrogenic Cushing syndrome is induced by long-term glucocorticoid therapy and presents with symptoms identical to those of naturally occurring Cushing syndrome. Prominent symptoms include hyperglycemia, glycosuria, fluid and electrolyte disturbances, osteoporosis, muscle weakness, cutaneous striations, and lowered resistance to infection. Redistribution of fat produces central obesity, a rounded face, and a fat pad at the cervical spine characteristic of Cushing syndrome and Cushing disease.

Question 59

What are some mild psychologic disturbances that can result from systemic glucocorticoid use, and what percentage of patients experience them?

Answer 59

Mild psychologic disturbances may include insomnia, anxiety, agitation, or irritability.
Approximately 60% of patients experience these mild reactions.

Question 60

What are severe psychologic disturbances that can occur due to systemic glucocorticoid use, and how common are they?

Answer 60

Severe psychologic disturbances may include delirium, hallucinations, depression, euphoria, or mania.
These severe reactions occur in approximately 6% of patients.

Question 61

What is the risk of suicidal tendencies in patients experiencing severe psychologic disturbances caused by glucocorticoids?

Answer 61

Up to one-third of patients experiencing severe psychologic disturbances may become suicidal.

Question 62

Does a history of previous psychiatric illness increase the risk of psychologic reactions caused by glucocorticoids?

Answer 62

No, a history of previous psychiatric illness does not appear to predispose patients to psychologic reactions caused by glucocorticoids.

Question 63

What complications related to the eyes can arise from long-term glucocorticoid therapy?

Answer 63

Long-term glucocorticoid therapy can lead to cataracts and open-angle glaucoma.

Question 64

What factors may contribute to the development of cataracts in individuals receiving glucocorticoid therapy?

Answer 64

Factors such as age, dosage, or individual susceptibility may contribute to the development of cataracts in individuals receiving glucocorticoid therapy.

Question 65

How do glucocorticoids affect the risk of peptic ulcer disease, and what can increase the risk of ulceration?

Answer 65

• Glucocorticoids can increase the risk of peptic ulcer disease by inhibiting prostaglandin synthesis and promoting factors that predispose to ulceration.
• Concurrent use of other ulcerogenic drugs, like aspirin and NSAIDs, further increases the risk of ulceration.

Question 66

What is iatrogenic Cushing syndrome, and what are some of its characteristic symptoms?

Answer 66

• Iatrogenic Cushing syndrome is a condition induced by long-term glucocorticoid therapy, presenting with symptoms identical to those of naturally occurring Cushing syndrome.
• Prominent symptoms include hyperglycemia, glycosuria, fluid and electrolyte disturbances, osteoporosis, muscle weakness, cutaneous striations, and lowered resistance to infection.
• Redistribution of fat leads to central obesity, a rounded face, and a fat pad at the cervical spine, characteristic of Cushing syndrome and Cushing disease.

Question 67

What is adrenal suppression, and why is it a concerning adverse effect of long-term glucocorticoid therapy?

Answer 67

Adrenal suppression is the inhibition of the adrenal glands’ ability to produce glucocorticoids due to the prolonged use of exogenous glucocorticoids.
It is concerning because when glucocorticoid therapy is discontinued, the adrenal glands may be unable to produce glucocorticoids, leading to adrenal insufficiency.

Question 68

How do glucocorticoids affect the release of CRH and ACTH from the hypothalamus and anterior pituitary, respectively?

Answer 68

Glucocorticoids suppress the release of CRH (corticotropin-releasing hormone) from the hypothalamus and ACTH (adrenocorticotropic hormone) from the anterior pituitary.

Question 69

What happens to the adrenal glands during prolonged glucocorticoid therapy?

Answer 69

The adrenal glands can atrophy and lose their ability to synthesize cortisol and other glucocorticoids due to the prolonged absence of ACTH.

Question 70

Why is adrenal insufficiency a concern when discontinuing prolonged glucocorticoid therapy, and how do patient responses vary?

Answer 70

Adrenal insufficiency is a concern because the adrenal glands may not immediately produce glucocorticoids when therapy is stopped, potentially leading to life-threatening situations.
Patient responses to adrenal recovery are highly individualized, and the time needed for recovery can range from as short as 5 days to as long as a year.

Question 71

What primarily determines the extent of adrenal suppression and the time required for adrenal recovery in patients receiving glucocorticoid therapy?

Answer 71

The duration of glucocorticoid use is the primary factor determining the extent of adrenal suppression and the time required for adrenal recovery.
Dosage size is of secondary importance in this context.

Question 72

Why is adrenal suppression concerning during periods of physiologic stress for patients on long-term glucocorticoid therapy?

Answer 72

Adrenal suppression can prevent the adrenal glands from secreting the larger amounts of glucocorticoids needed to cope with physiologic stress.

Question 73

What is the significance of glucocorticoid secretion during periods of stress, such as trauma or surgery?

Answer 73

During stress, glucocorticoids play a crucial role in supporting the body’s response and are essential for life, especially in cases of severe stress.

Question 74

What should be done for patients on long-term glucocorticoid therapy when they face periods of physiologic stress?

Answer 74

Patients on long-term glucocorticoid therapy should receive increased doses during times of stress, unless they are already on very high doses.

Question 75

Why might supplemental doses of glucocorticoids be necessary for patients even after discontinuing long-term glucocorticoid therapy during periods of stress?

Answer 75

After discontinuing glucocorticoid therapy, adrenal function may not have fully recovered. Thus, supplemental doses of glucocorticoids may be required during times of stress to ensure an adequate stress response.

Question 76

Why is caution required when combining glucocorticoids with certain drugs like digoxin?

Answer 76

Combining glucocorticoids with digoxin can increase the risk of digoxin-induced dysrhythmias due to hypokalemia caused by glucocorticoids.

Question 77

Which classes of diuretics should be used cautiously with glucocorticoids, and why?

Answer 77

Thiazide and loop diuretics should be used with caution alongside glucocorticoids because they can further deplete potassium levels, increasing the risk of hypokalemia.

Question 78

What monitoring is advisable when glucocorticoids are used in combination with drugs like digoxin and diuretics?

Answer 78

Monitoring plasma potassium levels is advisable to detect and address potential hypokalemia. Additionally, healthcare providers should remain vigilant for signs and symptoms of digoxin toxicity and fluid/electrolyte imbalance.

Question 79

Why is concurrent use of NSAIDs and glucocorticoids a concern?

Answer 79

Concurrent use of NSAIDs and glucocorticoids increases the risk of GI ulceration and bleeding due to their adverse effects on the GI tract.

Question 80

How can glucocorticoid therapy affect glycemic control in diabetic patients?

Answer 80

Glucocorticoids can induce hyperglycemia, necessitating adjustments in the doses of glucose-lowering drugs like insulin or oral hypoglycemic agents for diabetic patients.

Question 81

What impact can glucocorticoids have on vaccine effectiveness, and what is the concern with live virus vaccines?

Answer 81

Glucocorticoids possess immunosuppressant properties that can diminish antibody responses to vaccines. When live virus vaccines are administered alongside glucocorticoids, there’s an increased risk of both developing and spreading viral diseases.

Question 82

What are the contraindications for glucocorticoid use?

Answer 82

Glucocorticoids are contraindicated for patients with systemic fungal infections and those receiving live virus vaccines.

Question 83

In which patient populations should glucocorticoids be used with caution?

Answer 83

Glucocorticoids should be used with caution in pediatric patients.
Pregnant or breastfeeding women should also exercise caution when using glucocorticoids.

Question 84

What are some medical conditions that require caution when using glucocorticoids?

Answer 84

Caution is necessary in patients with conditions such as hypertension, heart failure, renal impairment, esophagitis, gastritis, peptic ulcer disease, diabetes mellitus, osteoporosis, open-angle glaucoma, and infections that are resistant to treatment.

Question 85

Why is caution required during concurrent therapy with glucocorticoids and certain medications?

Answer 85

Caution is needed when using glucocorticoids concurrently with potassium-depleting diuretics, digoxin, insulin, oral hypoglycemics, and NSAIDs due to potential interactions and risks associated with these combinations.

Question 86

How should patients take glucocorticoids in terms of timing and what can they do to reduce gastrointestinal discomfort?

Answer 86

Patients should take glucocorticoids in the morning to mimic the natural hormone release rhythm. Taking them with milk or a snack can help reduce gastrointestinal discomfort.

Question 87

What is the risk of abruptly discontinuing high or prolonged dosing of glucocorticoids, and what can happen during withdrawal?

Answer 87

Abrupt discontinuation of high or prolonged glucocorticoid dosing can lead to adrenal suppression, which can be life-threatening. Withdrawal symptoms may also occur.

Question 88

Why is it important for patients taking glucocorticoids to carry identification like a Medic Alert bracelet?

Answer 88

Carrying identification ensures proper dosing during emergencies, such as trauma, where higher glucocorticoid doses may be needed to mimic the normal stress response.

Question 89

How can glucocorticoids affect the risk of infection, and what should patients do if they suspect an infection?

Answer 89

Glucocorticoids can increase the risk of infection. Patients should be aware of early signs of infection, such as fever and malaise, and contact the clinic if these symptoms develop.

Question 90

What are the signs and symptoms of fluid retention and hypokalemia, and what should patients do if they experience them?

Answer 90

Signs of fluid retention include weight gain and lower extremity swelling. Signs of hypokalemia include muscle weakness, irregular pulses, and cramping. Patients should notify the prescriber if these symptoms occur.

Question 91

Why are regular eye examinations important during glucocorticoid therapy, and what should patients do if they notice changes in their vision?

Answer 91

Regular eye examinations help reduce the risk of cataracts and glaucoma associated with glucocorticoid use. Patients should contact the clinic if their vision becomes cloudy or blurred.

Question 92

How can glucocorticoids potentially affect the gastrointestinal system, and what should patients do if they notice specific changes?

Answer 92

Glucocorticoids can increase the risk of GI bleeding. Patients should avoid over-the-counter drugs without consulting the provider and contact the clinic if they observe black, tarry stools.

Question 93

What should patients be informed about regarding possible psychological reactions while taking glucocorticoids, and what should they do if they experience such reactions?

Answer 93

Patients should be informed about possible psychologic reactions and instructed to report disturbing symptoms. They should understand that dosage adjustments or other medications may be needed to manage these symptoms.

Question 94

What lab parameters should be assessed in patients taking glucocorticoids, and when should this assessment occur?

Answer 94

Patients on glucocorticoids should have CBC, glucose, electrolytes, and lipids assessed. Initially, this should be done in 1 month, followed by assessments every 6 to 12 months if the patient’s condition remains stable.

Question 95

Why is it important to conduct eye exams regularly in patients taking glucocorticoids, and how often should these exams be performed?

Answer 95

Regular eye exams are essential to monitor for potential ocular complications associated with glucocorticoid use. These exams should be conducted every 6 months.

Question 96

What should healthcare providers inquire about at each visit for patients on glucocorticoids, and what should they do if muscle weakness is reported?

Answer 96

Healthcare providers should ask about muscle weakness at each visit. If weakness is reported, they should assess the proximal muscle strength of extremities.

Question 97

How should stools be monitored in patients taking glucocorticoids, and when should testing be performed?

Answer 97

Stools should be periodically tested, such as with Hemoccult. Testing should also occur as needed if there are suspicions of GI ulceration or if the patient reports GI discomfort or black or red stools.

Question 98

How often should bone mineral density (BMD) be checked in patients on glucocorticoids, and what if it decreases from baseline?

Answer 98

BMD should be checked in 1 year and, if stable compared with baseline, every 2 to 3 years thereafter. If BMD decreases from baseline, it should be assessed annually.

Question 99

What metabolic parameters should be periodically assessed in patients taking glucocorticoids, and how often should this assessment occur?

Answer 99

Healthcare providers should periodically assess serum glucose and the metabolic panel as guided by the patient’s presentation.

Question 100

What vital signs and measurements should be assessed at every visit for patients on glucocorticoids?

Answer 100

Healthcare providers should assess blood pressure (BP) and body mass index (BMI) at every visit.

Question 101

In pediatric patients taking glucocorticoids, what specific parameter should be measured every 6 months?

Answer 101

In pediatric patients, healthcare providers should measure height every 6 months to monitor potential growth effects associated with glucocorticoid use.