Curso Abierto “Sistemas de Gestión Integrados de Calidad, Ambiente y Seguridad – Salud Ocupacional”
3, 5, 10 y 12 de Julio del 2018 – Santiago de Chile, Impartido para la Universidad del Desarrollo.
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Corticosteroid Adverse Effects
The use of corticosteroids is associated with a wide range of adverse effects, which
can occur due to their potent glucocorticoid activity.
The following are key points to consider:
Adrenal Suppression
Long-term or high-dose corticosteroid therapy may suppress the hypothalamic-pituitary-adrenal
(HPA) axis, leading to reduced production of endogenous cortisol.
This can result in:
Cortisol deficiency (e.g., adrenal insufficiency)
Adrenal atrophy
Thromboembolism and Vascular Disruption
Corticosteroids can contribute to hypercoagulation, increasing the risk of:
Deep vein thrombosis (DVT)
Pulmonary embolism
Atherosclerosis
Metabolic Disturbances
Changes in metabolism include:
Lipodystrophy
Fatty liver
Hyperglycemia and insulin resistance
Musculoskeletal Effects
Corticosteroids can lead to:
Osteoporosis (due to reduced bone density)
Amygdala enlargement
Proximal muscle weakness
Dermatological Adverse Effects
The skin may experience:
Acneiform eruptions
Facial discoloration
Hypertrichosis (excess hair growth)
Others
Additional potential effects include:
Immunosuppression
Eye changes (e.g., posterior subcapsular cataracts)
Neuropathy
Key Considerations
Risk factors for corticosteroid adverse effects include:
High doses or prolonged therapy
Individual susceptibility
Concurrent use of other medications (e.g., warfarin, NSAIDs)
It is essential to weigh the benefits and risks of corticosteroid therapy and consider alternative
treatments when possible.
Introduction
Corticosteroids are a class of drugs commonly used
in the treatment of various inflammatory conditions, immune disorders, and other
medical conditions. While these medications can be highly
effective, they are also associated with a spectrum
of potential adverse effects. Understanding these effects is critical for healthcare providers to safely and effectively manage patient care.
Account
Corticosteroids are derived from cholesterol and function as potent anti-inflammatory agents through their ability to suppress the immune
response and modulate the activity of cells involved
in inflammation. Their widespread use necessitates a thorough understanding of both
their therapeutic benefits and potential side effects.
Bookshelf
The NCBI Bookshelf StatPearls provides a comprehensive resource for healthcare professionals to access
information on drug dosing, indications, adverse effects, and
other clinical considerations. This tool is an invaluable resource
for staying updated on the latest guidelines and evidence-based practices in therapeutics.
StatPearls
The NCBI Bookshelf StatPearls platform is a widely used clinical decision-making tool
that offers detailed information on various drugs, including corticosteroids.
It allows users to quickly access key details such as indications, dosage guidelines, adverse effects,
and patient monitoring strategies.
Corticosteroid Adverse Effects
Adverse effects associated with corticosteroid use can range from mild to
severe and include a variety of clinical presentations.
Common side effects include:
– Glucocorticoid Resistance: A rare condition where the body’s cells become unresponsive to the therapeutic effects of corticosteroids, often leading to treatment failure.
– Adrenal Suppression: Long-term use can suppress the hypothalamic-pituitary-adrenal (HPA) axis, potentially
causing Addisonian crisis in susceptible individuals.
– Thromboembolic Events: An increased risk of blood clots,
which can lead to serious complications such as deep vein thrombosis and pulmonary embolism.
– Moon Face Syndrome: A rare condition characterized by a distortion of facial features
due to the redistribution of fat in the face.
Authors
The authors of this article are healthcare professionals with expertise in pharmacology, internal medicine, and clinical
practice. Their contributions ensure that the information presented is evidence-based,
accurate, and relevant to clinical practice.
Affiliations
The affiliations of the authors reflect their institutional roles and areas
of research expertise. This information provides readers with context about the qualifications and experience of those
contributing to the article.
Continuing Education Activity
This activity serves as a continuing education opportunity for healthcare professionals to enhance their knowledge and
skills in the use of corticosteroids and the management of associated adverse effects.
Indications
Corticosteroids are used in the treatment of a wide range of
conditions, including inflammatory bowel disease (IBD), autoimmune diseases such as rheumatoid arthritis,
and allergic disorders like asthma and chronic obstructive pulmonary disease (COPD).
Their efficacy in these conditions makes them a cornerstone
in modern therapeutic medicine.
Mechanism of Action
Corticosteroids exert their therapeutic effects by binding to
glucocorticoid receptors located on the surface of target cells.
This interaction leads to the suppression of pro-inflammatory genes, thereby reducing the
severity of inflammatory reactions and immune responses.
Administration
Corticosteroids are typically administered orally or via
inhalation, depending on the specific indication. Intravenous and intramuscular
routes are also used in certain cases. Proper dosing and route selection are critical to
achieving therapeutic benefits while minimizing adverse effects.
Adverse Effects
The risk of corticosteroid-related adverse effects is dose-dependent and increases
with the duration of treatment. Monitoring for common and serious side effects
is essential.
Contraindications
Corticosteroids are contraindicated in individuals with a history of hypersensitivity to the
drug, active or inactive tuberculosis (due to the risk of reactivation), and certain genetic conditions
that predispose to adrenal insufficiency.
Monitoring
Close monitoring of patients receiving corticosteroid therapy is necessary to
assess therapeutic response and detect adverse effects early.
Regular laboratory tests, including serum cortisol levels
and blood counts, can help guide adjustments in treatment.
Toxicity
Corticosteroid toxicity refers to the harmful effects that occur when the body is exposed
to excessive or prolonged levels of these hormones.
This toxicity can manifest as a variety of clinical symptoms, including muscle wasting,
bone demineralization, and the development of Cushings syndrome.
Enhancing Healthcare Team Outcomes
Effective communication and collaboration among healthcare team members are essential for optimizing patient outcomes in the context of corticosteroid therapy.
Regularly reviewing treatment plans and monitoring for adverse effects can help ensure that patients receive safe,
effective care.
Review Questions
To test your understanding of this article, consider answering
the following questions:
1. Which condition is associated with an increased risk of thromboembolic events in corticosteroid users?
a) Glucocorticoid resistance
b) Adrenal suppression
c) Thromboembolic events
d) Moon face syndrome
2. What is the primary mechanism of action for corticosteroids in inflammatory
conditions?
a) Inhibiting cytokine production
b) Blocking transcription factors involved in inflammation
c) Suppressing immune responses
d) Allowing cells to heal more quickly
3. Which route of administration is commonly used for corticosteroid therapy?
a) Intravenous
b) Subcutaneous
c) Oral
d) Inhaled
References
The information in this article is based on the NCBI Bookshelf
StatPearls resource. For further reading and
detailed guidelines, please refer to the following reference:
– NCBI Bookshelf – StatPearls Internet. U.S. National Library
of Medicine.
Views
The views expressed in this article are those of the authors and do not necessarily represent the views or policies of the institutions or organizations with which
they are affiliated.
In This Page
– Account: Overview of corticosteroid pharmacology and clinical use.
– Bookshelf: Access to detailed drug information via NCBI StatPearls.
– StatPearls: A clinical decision-making tool for healthcare providers.
Bulk Download
For bulk downloads or further access to the content, please refer to the related information section below.
Related Information
– Similar articles in PubMed: Search for “Corticosteroid Adverse Effects” to find related articles and research studies.
– Recent Activity: Stay updated with the latest advancements in corticosteroid research and clinical practice.
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