Corticosteroids Flashcards
what are the CI of steroids?
- avoid injections containing benzyl alcohol
- avoid live vaccines
- systemic infections
what are the cautions of steroids?
- congestive HF
- diabetes (including family History)
- diverticulitis
- epilepsy
- glaucoma
- history of steroid myopathy
- hypothyroidism
- intreated infection
- psychriatric reactions
- recent MI
- Peptic ulcer
explain the further info on the SE of adrenal supression:
- during prolonged systemic therapy, adrenal atrophy develops and can persist for years after stopping.
- abrupt withdrawal after prolonged therapy can lead to acute adrenal insufficiency, hypotension and sudden death.
explain the further info on the SE of infections:
prolonged courses of steroids increases the suspectibility to infections and severity.
explain the further info on the SE of chickenpox and measles:
unless pt has had chickenpox before, pts are at high risk of severe chickenpox.
immunisation of varicella- zoster vaccine is needed in non- immune pts.
confirmed chickenpox: immediate care needed. do not stop steroids and dose may need to be increased.
measles: avoid exposure to measles.
explain the further info on the SE of psychiatric reactions
- steroids, especially at high doses is linked to psychiatric reactions:
- (euphoria, insomnia, irritability, mood liability, suicidal thoughts, behavioural issues)
- usually subside on reducing the dose or stopping therapy.
- SEEK MEDICAL ATTENTION especially if depression, suicidal thoughts
gradual withdrawal of steroids should be considered in those who disease is unlikely to relapse and have….?
- received more than 40mg prednisolone (or eqiv) OD for more than a week.
- been given repeated doses in the evening
- received more than 3 weeks treatment
- recently received repeated courses (especially taken for longer than 3 weeks)
- taken a short course within 1 year of stopping long term therapy
what is the MHRA/CHM advice for steroids?
- rare risk of central choriretinopathy
- report any blurred vision or other visual disturbances
