[Corticosteroid therapy].
Synthetic corticosteroids have variable glucocorticoid and mineralocorticoid potencies. Depending on their galenic form they can be administered either by intravenous, oral, intraarticular, intramuscular, inhalative or topic route. A local application is preferable over a systemic administration to avoid side effects. An initially high dose should always be tapered to the lowest possible effective dose. Among the side effects some have substantial clinical implications: Osteoporosis (to be treated during any long-term steroid application with calcium, vitamin D and eventually bis-phosphonates), immunodeficiency and a risk for often atypical infections, diabetes mellitus and psychiatric disorders such a depression and psychosis. A long-term glucocorticoid treatment can lead to a permanent adrenal insufficiency (M. Addison), which must be recognized and properly managed.
Reinhart
W H
WH
Medizinische Klinik, Kantonsspital, Chur. walter.reinhart@scag.gr.ch
D000224:Addison Disease / Q000139:chemically induced; D000280:Administration, Inhalation; D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000465:Algorithms; D002648:Child; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006130:Growth Disorders / Q000139:chemically induced; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000737:chemistry; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects; D007262:Infusions, Intravenous; D007270:Injections, Intra-Articular; D007273:Injections, Intramuscular; D001523:Mental Disorders / Q000139:chemically induced; D010024:Osteoporosis / Q000139:chemically induced / Q000188:drug therapy; D010913:Pituitary-Adrenal System / Q000187:drug effects; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D005938:Glucocorticoids; D006854:Hydrocortisone