Steroids Flashcards
steroids S/E?
CUSHINGOID mnemonic
Cataracts Ulcers Striae and skin thinning Hypertension and hirsutism Immunosuppression and infection Necrosis of femoral head Glucose elevation Osteoporosis and obesity Impaired wound healing Depression and mood changes
what to prescribe alongside long term steroids?
give PPI and BISPHOSPHONATE
Sx of severely hydrocortisone depleted Addisons patient? (ie, very unwell and on normal steroid dose)
postural drop in BP
always increase steroids if unwell
how do steroids cause stomach ulcers?
inhibit gastric tissue renewal
steroids and HF?
avoid!
effect of steroids on wbc?
↑ (non-infective)
Steroid S/E?
“STEROIDS” mnemonic
Stomach ulcers Thin skin oEdema Right and L HF OP Infection (candida) DM (↑ glucose) Cushings Syndrome
long term steroid sick day rules?
double the dose
5mg pred is = to how much hydrocortisone?
20mg hydrocortisone
Tx flare of RA?
long term Tx RA?
IM methylprednisolone 80 mg
ibuprofen + PPI
- methotrexate + DMARD (sulfasalazine or hydroxychloroquine)
- failure to respond to two DMARDs, TNF-α inhibitors, e.g. infliximab
when to give dose of prednisolone?
morning after breakfast (bc cortisol peaks here)
how to give hydroocortisone for adrenal replacement?
diurnal mimic - larger dose in the morning and smaller in the evening
when to consider gradual withdrawal of systemic corticosteroids?
- > 40 mg prednisolone (or equivalent) daily for > 1 week;
- been given repeat doses in the evening;
- received > 3 weeks’ treatment;
- recently received repeated courses (particularly if taken for longer than 3 weeks);
- taken a short course within 1 year of stopping long-term therapy;
- other possible causes of adrenal suppression.
Systemic corticosteroids may be stopped abruptly in those whose…?
disease is unlikely to relapse
and have received treatment for 3 weeks or less
