Rheumatology Question 23 Instructor

Corticosteroids are often used to gain rapid control of an inflammatory process. In most situations they are eventually tapered and replaced with less toxic “steroid-sparing” agents.

List 10 adverse consequences of corticosteroid therapy. What parameters should be monitored in a patient on prednisone therapy?

Adverse consequences of corticosteroid therapy include the following:

  1. Weight gain and altered fat distribution leading to the classical Cushingoid appearance. This is characterized by truncal obesity, a dorsal fat pad, and moon facies.
  2. Hirsutism
  3. Acne
  4. Psychiatric disturbances, including depression, anxiety and rare psychoses
  5. Hypertension
  6. Hyperglycemia and insulin resistance
  7. Increased susceptibility to infection
  8. Skin changes including striae, bruising
  9. Muscle weakness
  10. Osteoporosis
  11. Osteonecrosis
  12. Cataract formation
  13. Glaucoma

Patients taking corticosteroids should have regular blood pressure monitoring. Patients on higher doses may require blood glucose testing. Chronic use necessitates baseline and follow-up bone mineral densitometry.

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