Side effects of corticosteroid treatment include:
- Musculoskeletal
- Osteoporosis
- Fractures – 12%
- Avascular necrosis of femoral head (high doses)
- Proximal myopathy
- Gastrointestinal
- Peptic ulceration
- Acute pancreatitis
- Endocrine
- Weight gain
- Diabetes
- Adrenal suppression
- Hypercholesterolaemia/hyperlipidaemia
- Menstrual disturbances
- Skin
- Acne
- Skin bruising/thinning
- Hirsutism
- Other
- Sleep disturbance
- Mood disturbance
- Cataracts -15%
- Glaucoma
- Hypertension
- Increased susceptibility to infection
Adrenal suppression may occur after just 5 days of high dose steroids, and can occur even at low doses after prolonged use.
Significance of adrenal suppression:
- When stopping dose should be tapered rather than abruptly stopped
- Increased dose is required during illness
- Dose required during induction for surgery and increased dose afterwards
References