STEROID COUNSELLING

Question 1

How would you start the steroid counselling?

Answer 1

Brief history

SPIKES

ICE and chunk and check throughout

Question 2

How do steroids work and when do you take them?

Answer 2

Reduce inflammation and reduce immune response

Taken in the morning

Question 3

When might a patient be required to carry a steroid record card?

Answer 3

3+ weeks of high dose prednisolone

Long term steroid treatment of Addison’s disease

Question 4

What do you do if you miss a dose of steroids?

Answer 4

Take it as soon as you remember

If it’s the next day, just skip the dose

Question 5

Monitoring for steroid treatment?

Answer 5

Children - height and weight

Adults - None

Question 6

Advice on stopping steroids?

Answer 6

Can’t stop them abruptly bc can precipitate adrenal crisis

Need to taper down with GP guidance

Question 7

Side effects of steroid therapy

Answer 7

Common: headaches, swollen ankles, fatigue, GI upset and indigestion

Less Common: rounding of the face, muscle wasting, thinning of bones

Psych: depression, insomnia, psychosis (rare)

Others: stomach ulcers, dampened immune system

Question 8

Sick day rules?

Answer 8

Double steroid dose on sick days