Corticosteroids side -effects
Corticosteroids
Side Effects
Short stature (check midparental, puberty, velocity)
Weight gain (Wt)
Striae
Cushingoid
Acne
Facial erythema
Skin thinning
Bruising
Fluid retention
Hypertension
Arythmia (K)
gastritis/PUD
Steatohepatitis (LFT)
Visceral perforation
Neutrophilia (FBE)
immunosuppression (?PCP prophylaxis)
Hyperglycaemia (BSL)
HPA insufficiency (hypoglycaemia ?sz with stress)
Growth impairment (Ht) (less with alternate day)
Cataracts
Glaucoma
Osteoporosis (Ca, PO4, PTH, BMD scan)
Avascular necrosis
Myopathy
Insomnia
Depression
Mania
Psychosis
UA for glycosuria
Ix
Na low, K high, Ur high ?Adrenal suppression > short synACTHen (cortisol pre, 30m, 60m)
- normal increment 200nmol/L normal peak >500nmol/L
Minimise flairs requiring Rx
Lowest dose, shortest time
Steroid cover letter
- PO
- IM in not tolerating
Side Effects
Short stature (check midparental, puberty, velocity)
Weight gain (Wt)
Striae
Cushingoid
Acne
Facial erythema
Skin thinning
Bruising
Fluid retention
Hypertension
Arythmia (K)
gastritis/PUD
Steatohepatitis (LFT)
Visceral perforation
Neutrophilia (FBE)
immunosuppression (?PCP prophylaxis)
Hyperglycaemia (BSL)
HPA insufficiency (hypoglycaemia ?sz with stress)
Growth impairment (Ht) (less with alternate day)
Cataracts
Glaucoma
Osteoporosis (Ca, PO4, PTH, BMD scan)
Avascular necrosis
Myopathy
Insomnia
Depression
Mania
Psychosis
UA for glycosuria
Ix
Na low, K high, Ur high ?Adrenal suppression > short synACTHen (cortisol pre, 30m, 60m)
- normal increment 200nmol/L normal peak >500nmol/L
Minimise flairs requiring Rx
Lowest dose, shortest time
Steroid cover letter
- PO
- IM in not tolerating