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Saturday 16 August 2014

Steroids - YES or NO?

Short-Term Side Effects of Systemic Steroids

Most people receive systemic steroids for only a few days at a time, and experience only temporary side effects. These may include an increase in appetite, difficulty sleeping (insomnia), changes in mood and behavior, flushing (redness) of the face, and short-term weight gain due to increased water retention. These side effects usually resolve after a few days once the steroids have been stopped.
People with underlying medical conditions might also notice other side effects. Those with diabetes mellitus may see an increase in their blood sugar readings; those with high blood pressure may see their blood pressure readings rise. People with glaucoma could have an increase of the pressures within their eyes; people with congestive heart failure may retain water and have worsening of this condition. For this reason, a person with any chronic underlying disease should be closely followed by their physician while taking systemic steroids.

Long-Term Side Effects of Systemic Steroids

When systemic steroids are used for long periods of time, or when steroids are taken on multiple occasions, more serious side effects may occur. It is for these reasons that the dose and duration of systemic steroids should be minimized whenever possible. Some side effects can be decreased by taking systemic steroids every other day instead of daily, even if the total dose is the same. Many of the side effects are reversible if the steroids are stopped, while other side effects may be permanent.
Side effects of long-term steroid use includes:
  • Glaucoma
  • Cataracts
  • High-blood pressure
  • Heart disease
  • Diabetes mellitus
  • Obesity
  • Acid reflux/GERD
  • Osteoporosis
  • Myopathy
  • Increase in certain types of infections
  • Cushing syndrome
People taking long-term systemic steroids should be closely monitored for the above diseases, and should take medicines to prevent osteoporosis. These medicines may include supplemental calcium and vitamin D, along with medicines to prevent bone loss called bisphosphonates. Examples of bisphosphonates include alendronate (Fosamax), risedronate (Actonel) and ibandronate (Boniva). Frequent measuring of bone-mineral density should also be performed in people taking long-term systemic steroids.
Learn about the side effects of inhaled steroids and nasal steroids.
Source:
Schleimer RP, Spahn JD, Covar R, Szefler SJ. Glucocorticoids. In: Adkinson NF, Yunginger JW, Busse WW, et al, eds. Middleton’s Allergy Principles and Practice. 6th edition. Philadelphia: Mosby Publishing; 2003:870-914.
DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.

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