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Corticosteroids
- 10mg Prednisolone= 8mg Methylprednisolone= 1.5mg Dexamethasone
- Side effects- Infections, weight gain, acne, delayed wound healing, osteoporosis (induces apoptosis of osteoblasts), steroid myopathy, mood changes, hypokalemia, insomnia, hypertension, hyperglycemia
- Monitor BG levels and insulin as per "management of hyperglycemia" section
- Causes gastritis, hence add, Pantoprazole- 40mg- OD
- For osteoporosis following must be advised
- Regular weight bearing exercises
- Stop smoking and alcohol
- Calcium- Adults- 1000mg/day
- Vitamin D- Adults- 800 units/ day
- For patients aged 40-90 years, who are on long term steroids (>3 months)- Give bisphosphonates
- Contraindications- Untreated serious infections, active tuberculosis, serious fungal infection, ocular herpes, untreated hypertension, untreated diabetes mellitus, cirrhosis
- Taper if used for long time. Sudden stopping causes acute adrenal insufficiency. This presents with nausea, vomiting, abdominal pain, dehydration, hyponatremia, weakness, lethargy, hypotension. Treat with IV NS/DNS, Hydrocortisone 100mg (or Dexamethasone 4mg) stat and TDS
Name | Dose (Adults) | Dose (Paediatric) | Available as |
| Hydrocortisone | 100-500mg- Stat Can repeat 6th hrly | 5-10mg/kg- QID | |
| Methyl prednisolone | Depends on indication | ||
| Prednisolone | 1-2mg/kg- OD/in divided doses | 1-2mg/kg- OD | Syp. 10mg, 5mg/5ml |
| Dexamethasone | 4mg- TDS Severe cases- 40mg OD for 4 days |
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