Glucocorticoids

Glucocorticoids

Comment On Adverse Effects Of Glucocorticoids.
Or
Write A Short Note On the Adverse Effects Of Glucocorticoids.
Or
Write A Short Note On The Adverse Effects Of Corticosteroids.
Answer:

The adverse effects of Glucocorticoids are:

• Cushing’s habitus: Abnormal fat distribution which leads to characteristic appearance with a rounded face, narrow mouth, supraclavicular hump, obesity of trunk with relatively thin limbs.
• The fragile skin and purple striae: Present typically on thighs and lower abdomen, easy bruising, telangiectasis, hirsutism. Cutaneous atrophy localized to the site occurs with topical application as well.
• Hyperglycemia: It may be glycosuria or the precipitation of diabetes.
• Muscular weakness: Proximal (shoulder, arm, pelvis, thigh) muscles are primarily affected. Myopathy occurs occasionally, and warrants withdrawal of the corticoids.
• Susceptibility to infection: Long-term therapy with steroids leads to the fire-up of opportunistic infections like viral, fungal, and bacterial.
• Delayed healing: There is delayed healing of wounds and surgical incisions.
• Peptic ulceration: Risk is doubled; bleeding and silent perforation of ulcers may occur. Dyspeptic symptoms are frequent with high-dose therapy.
• Osteoporosis: Especially involving vertebrae and other flat spongy bones. Compression fractures of vertebrae and spontaneous fractures of long bones can occur, especially in the elderly.
• Avascular necrosis: Avascular necrosis of the head of the femur, humerus, or knee joint is an occasional abrupt onset complication of high-dose corticosteroid therapy.
• Eye: Posterior subcapsular cataracts may develop after several years of use, especially in children. Glaucoma may develop in susceptible individuals after prolonged topical therapy.
• Growth retardation: It occurs in children even with small doses if given for long periods. Large doses do inhibit growth hormone secretion, but growth retardation may, in addition, be a direct cellular effect of corticoids. Recombinant growth hormone given concurrently can prevent growth retardation, but the risk/benefit of such use is not known.
• Psychiatric disturbances: The presence of mild euphoria frequently accompanies high-dose steroid treatment. This may rarely progress to manic psychosis. Nervousness, decreased sleep, and mood changes occur in some patients. Rarely a depressive illness may be induced after long-term use.
• Suppression of hypothalamo—pituitary—adrenal (HPA) axis: This occurs depending both on the dose and duration of therapy. In time, adrenal cortex atrophies and stoppage of exogenous steroids precipitates withdrawal syndrome consisting of malaise, fever, anorexia, nausea, postural hypotension, electrolyte imbalance, weakness, pain in muscles and joints, and reactivation of the disease for which they were used. Subjected to stress, these patients may go into acute adrenal insufficiency leading to cardiovascular collapse.