The major problems, caused mainly by high concentrations over a long period of time, include development of cushingoid habitus. Particularly in women, pts will developtrunkal obesity, moon facies, and buffalo hump. Salt retention and hypertension can also occur. The immune system is markedly suppressed, this can be advantageous in treating an autoimmune disease or for a transplant patient to ward off rejection of the new tissue, but the pt becomes vulnerable to opportunistic infections. Osteoporosis caused by chronic steroid use can render pts vulnerable to fractures. Peptic ulcers can result from gastric hemorrhages or intestinal perforation, if you throw in an NSAID on top of the pt’s corticosteroid dose the ulcer can be severely aggravated. Corticosteroids can suppress growth in children. Also, corticosteroids can cause CNS problems and psychoses. Finally, if a pt is on any of these steroids (not by inhalation) they have suppression of they hypothalamic-pituitary-adrenal axis after drug discontinuation.
Category:
Pharmacology Notes
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