title: Prevention and management of glucocorticoid-induced side effects: A comprehensive review: A review of glucocorticoid pharmacology and bone health.
abstract: Systemic glucocorticoids are an essential therapy for a range of conditions, but their multiple side effects can produce significant morbidity for patients. The objective of this review is to discuss these side effects while addressing 3 questions: 1) What dose and duration of glucocorticoid therapy should prompt concern for individual side effects?; 2) How should clinicians counsel patients about these complications?; and 3) How can these problems be prevented or managed? To accomplish these objectives, we have created a series of tables and algorithms based on a review of relevant data to guide counseling, prophylaxis, and management of 11 glucocorticoid side effects. The first article in this 4-part continuing medical education series begins with a review of glucocorticoid pharmacology followed by a discussion of bone health (ie, osteoporosis and osteonecrosis).
authors.affiliation: Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Avrom
authors.initials: A
authors.lastname: Caplan
authors.affiliation: Department of Dermatology, Oregon Health and Science University, Portland, Oregon.
authors.forename: Nicole
authors.initials: N
authors.lastname: Fett
authors.affiliation: Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Misha
authors.initials: M
authors.lastname: Rosenbach
authors.affiliation: Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Victoria P
authors.initials: VP
authors.lastname: Werth
authors.affiliation: Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: robert.micheletti@uphs.upenn.edu.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Micheletti
mesh_terms: D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D005938:Glucocorticoids / Q000009:adverse effects* / Q000494:pharmacology*; D006801:Humans; D010020:Osteonecrosis / Q000139:chemically induced* / Q000188:drug therapy* / Q000517:prevention & control; D010024:Osteoporosis / Q000139:chemically induced* / Q000188:drug therapy* / Q000517:prevention & control
chemical_list: D050071:Bone Density Conservation Agents; D005938:Glucocorticoids
keywords: glucocorticoids; medication monitoring; osteonecrosis; osteoporosis; pharmacology; side effects; steroids