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:
- 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.
- Hirsutism
- Acne
- Psychiatric disturbances, including depression, anxiety and rare psychoses
- Hypertension
- Hyperglycemia and insulin resistance
- Increased susceptibility to infection
- Skin changes including striae, bruising
- Muscle weakness
- Osteoporosis
- Osteonecrosis
- Cataract formation
- 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.
