Overdosage or prolonged use can exaggerate some of the normal physiological actions of corticosteroids leading to mineralocorticoid and glucocorticoid side - effects.
Mineralocorticoid side-effects include hypertention, sodium and water retention, and potassium and calcium loss. They are most marked with fludrocortisone, but are significant with hydrocortisone, corticotropin, and tetracosactide. Mineralocorticoid actions are negligible with the high potency gucocrticoids, betamethasone and dexamethasone, and occur only slightly with methlprednisolone, prednisolone, and tiamcinolone.
Glucocorticoid side-effects include diabetes and oesteoporosis, which is a danger, paticulaly in the elderly, as it can result in osteoporotic fractures for example of the hip or vertebrae; in addition high doses ae associated with avasculat necrosis of the femora head. Muscle wasting (proximal myopathy) can also occur. coticosteroid therapy is also weakly linked with peptic ulceration and perforation; there is no conclusive evidence that the use of enteric-coated preparations of prednisolone reduces the risk of peptic ulceration.
High doses of corticosteroids can cause Cushing's syndrome, with moon face, stiae, and acne; it is usually reversible on withdrawal of treatment, but this must always be gradually tapered to avoid symptoms of acute adrenal insufficiency.
In children, administration of corticosteroids may result in suppression of growth.
Side-Effect can be minimised by using lowest eefective dose for minimum period of time possible.
Other side-effects include; gastro-intestinal effects; dyspepsia, abdominal distension, acute pancreatitis, oesophageal ulceration and candidiasis; musculoskeletal effects; muscle weakness, vertebral and long bone fractures, tendon rupture, endocrine effects; menstrual irregularities and amenorrhoea, hirsutism, weight gaine, hypercholetarolaemia, hyperlipidaemia, negetive nitrogen and calcium balance, increased appetite; increased susceptibility to and severity of infection, reactivation of dormant tubercuolsis etc....
Comments
Post a Comment