Dealing with side effects of prednisone
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 as the dose of outside steroid exceeds the average daily equivalent output of the adrenal glands which is about 5.0-7.5 mg prednisone, therapy continues for more than a few weeks or months, doses are given late in the day or in split doses, 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. Tyr 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. Tyr to lower dose. Insomnia. Take medicines in AM. Lowest possible dose. Bowel perforation. Index of suspicion in patient who has a distended abdomen. Masking of infection. Vigilance.
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