Steroids

Question 1

Corticosteroids are useful adjuvant analgestics for:

Answer 1

bone, neuropathic and visceral pain

Question 2

How long are steroids most helpful for?

Answer 2

1-3 weeks

Question 3

Common side effects of steroids?

Answer 3

Hyperglycemia, Cushing syndrome, psychiatric complications (delirium, agitation, anxiety), proximal muscle myopathy, pseudorheumatism (after prolonged use or withdrawal of prolonged use )

Question 4

Which steroids are used and why?

Answer 4

Dexamethasone (5-8 times more potent than prednisolone), has minimal mineralocorticoid effect, therefore, causing less fluid retention. Prednisolone cause less proximal myopathy.

Question 5

Recommended steroid dose for pain?

Answer 5

It is not completely known, usually: 4-8 mg PO/SC, increase the dose with more severe pain

Question 6

What is recommended for steroid tapering down?

Answer 6

May be stopped abruptly if Tx under 2 weeks, otherwise taper down over days: 25% reduction every 2-3 days