Dealing with side effects of prednisone
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
Taking glucocorticoids orally or intravenously can lessen the ability of the person’s own adrenal glands to manufacture glucocorticoids.
Without the ability to increase steroid production in the face of stressors such as injury, infection, and surgery, a patient can go into shock.
The chances of the adrenal glands being suppressed increase with the following:
1. the dose of “outside” steroid exceeds the average daily equivalent output of the adrenal glands which is about 5.0-7.5 mg prednisone,
2. therapy continues for more than a few weeks or months,
3. doses are given late in the day or in split doses,
4. or long-acting corticosteroid preparations are used.
Taking steroids on an alternate day (every other day) schedule lessens the chance of adrenal insufficiency but does not eliminate it. Bottom line: taper slowly and carefully.
Other side-effects include and how to deal with them are:
• Increased risk of bacterial or opportunistic infections such as fungi, tuberculosis, pneumocystis carinii. Use caution. With any fever, suspect infection until proven otherwise.
• Elevated blood sugar. Try to lower steroid dose. Monitor blood sugar carefully.
• Fat distribution changes leading to moon face, buffalo hump. Use the lowest possible dose and taper as quickly as possible.
• Elevated blood lipids. Watch diet. Exercise. Lower dose when feasible.
• Aggravation of hypertension. Lower dose when possible.
• Electrolyte abnormalities such as low blood potassium. Keep close eye on this especially in patients on diuretics.
• Fluid retention leading to edema. Limit salt intake. Compression stockings.
• Easy bruisibility. Lower dose when possible.
• Increased body hair. Lowest possible dose.
• Increased sweating. Lowest possible dose.
• Purple stretch marks. Lowest possible dose.
• Impaired wound healing. Lowest possible dose.
• Glaucoma. Lowest possible dose.
• Cataracts. Lowest possible dose.
• Muscle wasting. Try to lower dose or switch to alternate day.
• Stomach ulcers. Avoid non steroidal drugs.
• Pancreatitis. Lowest possible dose.
• Accelerated hardening of the arteries. Diet, exercise, lowest possible dose.
• Osteonecrosis (bone death). Try to avoid high doses.
• Psychiatric disturbance. Try to lower dose.
• Insomnia. Take medicines in AM. Lowest possible dose.
• Bowel perforation. Suspect this in patient who has a distended abdomen.
• Masking of infection. Vigilance.
Get more information about dealing with side effects of prednisone and other issues as well as...
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Click here Second Opinion Arthritis Treatment Kit
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