Side effects Flashcards
1
Q
Corticosteroid patient counselling
A
- Report any signs of infection
- Report any behavioral changes / suicidal
- Take with or just after food
- Take with bisphosphonate to reduce OP risk
- Risk of adrenal suppression - Don’t abruptly withdraw if >3 weeks, >40mg prednisolone daily or >1week, repeat doses taken in evening, recent repeated courses, other causes of adrenal suppression e.g. Addison’s disease, short course within 1 year of stopping long-term steroid
2
Q
Management of side effects
A
- lowest effective dose for minimum time
- local treatment rather than systemic
- single dose in the morning - suppressive action on cortisol secretion is least in morning
4, alternative day administration - take two days worth as single dose to further reduce adrenal suppression - Intermittently and short courses
3
Q
Side effects
A
“ACHING BOSOM”
- Adrenal suppression - fatigue, anorexia, nausea, vomiting, hyponatremia, hypotension, hyperkaliemia, hypoglycemia. 1 year after stopping.
* Avoid abrupt withdrawal if use >3 weeks = acute adrenal insufficiency, hypotension, death! - Cushing’s syndrome and cataracts
- Hyperglycemia = diabetes
- Infection - avoid close contact with chickenpox and shingles and measles
- Nervous system - paranoia / depression and suicide risk whilst taking or on withdrawal. Mood and behavioral changes e.g. insomnia, euphoria, irritability, psychotic reactions. Aggravated epilepsy and schizophrenia
* Report immediately - Glaucoma and GI irritation
- MRHA warning: rare risk of central serous chorioretinopathy.
* Report blurred vision/disturbances and refer to ophthalmologist
- take with or just after food - Blood pressure increase
- Osteoporosis - if use >3months, give bisphosphonate. High corticosteroid doses cause avascular necrosis of femoral head
- Skin thinning, purple-red striae, bruising
- Obesity
- Muscle wasting - caution with stating and reduced growth in children
