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SYSTEMIC CORTICOSTEROIDS  A FRIEND OR A FOE Systemic Steroids are extremely effective as an anti inflammatory agent and immunosuppressive… useful to treat various diseases. In some cases, they may be life-saving and need to be continued for a longer period. We all know that long term uses of systemic corticosteroids has several side effects… at times these side effects badly affects the patient's quality of life.. Let's recapitulate them…              (1)Altered Response to Physical Stress.. This effect can last for a long even after steroid discontinuation              (2)Steroid Withdrawal Syndrome.. Rapid withdrawal of steroids, particularly if  taken for more than two weeks,              (3)Infection Long-term steroids can suppress the immune system and increase risk of infection.             (4)Gastrointestinal Ulcers or Bleeding            (5)Osteoporosis, with an increase in fracture risk           (6)Weight gain            (7)Insomnia, especially when they are taken in the evening.              (8)Mood Changes Especially in doses over 30 milligrams per day of prednisolone or equivalent             (9)Fluid Retention and Hypertension.            (10)Elevated Blood Sugar,  long-term use may lead even to diabetes.             (11)Eye Problems, can cause cataracts or glaucoma or worsen these conditions if they are already present.            (12)Aseptic Necrosis, can occur in a number of bones, but the bone at the hip joint is the most common.             (13)Myopathy mostly affecting shoulders and thighs muscles..              (14) Hypokalemia causing general weakness             (15) on Reproductive system… Irregular menstruation, Hirsutism, Lowered fertility, fetal growth retardation if Patient on prolonged course           (16)Atherosclerosis We must monitor our patients for the development these side effects.. Few of them are avoidable. We should have periodical examination & investigations to minimize these. Monitor Blood sugar.. Potassium. Calcium.. Add calcium supplements.. And PPI.. Add diuretics if needed.. Restrict calories intake.. Periodically eye examination.. Etc..
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