Steroid Dependence

Question 1

What are the complications of steroids?

Answer 1

Weight / metabolic syndrome 
Sleep disturbance 
Immunosuppression 
Increased BP/bradycardia 
Hyperglycaemia / steroid induced diabetes 
Increased appetite
Behaviour change 
Growth disturbance 
Osteopenia 
Low mood/affect 
Poor body image
Raised ICP
Gastritis
Pain

Question 2

Management of long term steroids

Answer 2

Check ADHERENCE
Can you reduced dose/use steroid sparing agents
- DEXA/Vit D + Ca2+
- PPI
- SSRI
Emergency plan: stress dosing for when unwell, medic alert bracelet
Consider extra vaccinations