Corticosteroid

Question 1

What are the common side effects of glucocorticoids?

Answer 1

• Impaired glucose regulation
• Increased appetite/weight gain
• Hirsutism
• Hyperlipidaemia
• Cushing’s syndrome
• Moon face
• Buffalo hump
• Striae
• Osteoporosis
• Proximal myopathy
• Avascular necrosis of the femoral head
• Immunosuppression
• Increased susceptibility to severe infection
• Reactivation of tuberculosis
• Insomnia
• Mania
• Depression
• Psychosis
• Peptic ulceration
• Acute pancreatitis
• Glaucoma
• Cataracts
• Suppression of growth in children
• Intracranial hypertension
• Neutrophilia

Side effects are more common with systemic and prolonged therapy.

Question 2

What are the mineralocorticoid side effects?

Answer 2

• Fluid retention
• Hypertension

These side effects can impact cardiovascular health.

Question 3

True or false: Patients on long-term steroids should have their doses doubled during intercurrent illness.

Answer 3

TRUE

This is a critical guideline for managing patients on corticosteroids.

Question 4

What should be done to avoid an Addisonian crisis when withdrawing corticosteroids?

Answer 4

Gradual withdrawal

Abrupt withdrawal can precipitate an Addisonian crisis due to suppressed natural steroid production.

Question 5

According to the BNF, gradual withdrawal of systemic corticosteroids is suggested if patients have received more than _______ mg prednisolone daily for more than one week.

Answer 5

40 mg

This guideline helps prevent withdrawal symptoms.

Question 6

According to the BNF, gradual withdrawal of systemic corticosteroids is suggested if patients have received treatment for more than _______ weeks.

Answer 6

3 weeks

This is to ensure safe discontinuation of corticosteroids.

Question 7

What is a common psychiatric side effect of glucocorticoids?

Answer 7

• Insomnia
• Mania
• Depression
• Psychosis

These effects can significantly impact mental health.

Question 8

What is the action of PPI?

Answer 8

irreversible blockade of H+/K+ ATPase of the gastric parietal cell.

Question 9

What are the side effects of PPI?

Answer 9

hyponatraemia, hypomagnasaemia
osteoporosis → increased risk of fractures
microscopic colitis
increased risk of C. difficile infections