Major points

  1. Steroids are synthetic hormones that have anti-inflammatory and immune suppressive effects.
  2. Commonly used in the treatment of various immune diseases.
  3. If you have a history of diabetes, peptic ulcer and pulmonary tuberculosis, you should pay attention to the use of steroids.
  4. Please follow the doctor's instructions to take the medicine on time and do not stop the medicine on your own.

 

What are steroids?

Steroids are artificial hormones that have the same function as the cortisol secreted by the adrenal cortex in the body. It has anti-inflammatory, anti-allergic, immunosuppressive and other functions, and can maintain physiological functions. If the secretion of steroids cannot be increased due to diseases or certain factors, it may cause life-threatening. Therefore, it is important to understand the use of steroids and precautions for medication.

 

What are the common usage?

Steroids are widely used to diminish inflammation and treat various immune diseases, such as rheumatoid arthritis, lupus erythematosus, polymyositis, nephrotic syndrome, vasculitis, asthma, allergic diseases, autoimmune diseases, blood diseases, or organ transplantation and adrenal insufficiency.

The commonly used dosage forms are as follows:

  1. Oral tablets: Prednisolone 5mg, Methylprednisolone 4mg etc.
  2. Intravenous injection: Solu-Medrol 125mg, 500mg, 1000mg etc.
  3. Topical steroid: Locacorten, Nerisone, Randerson-V, Topicon etc.
  4. Inhaled steroid: Beclomethasone dipropionate, Budesonide, Fluticasone propionate, Ciclesonide etc.

 

Principles of care:

Inform the doctor or seek medical attention in the following situations:

  1. If abdominal pain, back pain, dizziness, vomiting, long-term anorexia, muscle and joint pain, shortness of breath, rapid weight loss, frequent or persistent headache of unknown cause, fatigue or disease recurrence will occur after dosage reduction or drug withdrawal, seek medical advice immediately.
  2. People with a history of peptic ulcer, psychosis, uncontrolled diabetes, osteoporosis, glaucoma, and tuberculosis should inform the physician before using steroids.
  3. During medication, patients should inform physician before receiving skin test, any surgery (including tooth extraction) or if they contracted an infection or suffered from injury.
  4. During medication, if patients experience abnormal weight gain, lower limbs edema, muscle weakness, irregular menstruation, tarry stools, vomiting, fever or infection, then they should seek medical attention immediately.
  5. If urticaria,dyspnea, general redness, contact dermatitis, intractable eczema, and other adverse reactions occur after using the drug, then patients should inform medical staff immediately. Steroid-induced systemic allergies are relatively rare, are more frequent in patients with aspirin-exacerbated asthma disease.
  6. Precautions when using steroids :
    1. Don't take it on an empty stomach, but take it with food or immediately after a meal.
    2. Drug storage should avoid high temperature or humidity to prevent drug decomposition.
    3. If the inhalation dosage form is used, rinse your mouth after each use to reduce the residual steroid in your mouth, causing mold infection and white plaque in your mouth mucosa.
    4. If you stop taking the drug by yourself, there will be withdrawal syndrome, such as general malaise, muscle joint pain, mild fever, headache, diarrhea, lethargy and other symptoms. In severe cases, it will cause the body to be unable to function normally, and the autoimmune system can't be controlled, resulting in disease recurrence or even death. Therefore, you must take the medicine on time according to the doctor's advice, and don't stop or reduce the medicine by yourself, so as to effectively achieve disease control.
    5. If you forget to take the medicine, please make up the dosage according to the time of taking the medicine.
      1. For once a day dosing: take it as soon as you remember. If you do not remember until the night, skip the missed dose and return to your usual dosing times. Do not take a double dose.
      2. For more than once a day dosing: take it as soon as you remember. If you remember at the time for the next dose, take both doses.
      3. For every other day dosing: take it as soon as possible if it is the same day morning as the missed dose. If you do not remember until the night, skip the missed dose and take the missed dose in the following day. Then, take the next one every other day, for example, take the medicine in a single day shift to a double day.

 

Reference

  1. Chotiyarnwong, P., & McCloskey, E. (2020). Pathogenesis of glucocorticoid-induced osteoporosis and options for treatment. Nature Reviews Endocrinology, 16(8), 437-447. https://doi.org/10.1038/s41574-020-0341-0
  2. Huang, S. F., & Chuang, M. L. (2019). The role of corticosteroid in acute respiratory distress syndrome. Journal of Internal Medicine of Taiwan, 30(5) 305-313.https://doi.org/10.6314/JIMT.201910_30(5).02
  3. Yen, Y.N & Chen, M. H.(2021).Glucocorticoid-induced osteoporosis.Clinical Medicine,87(3),189-191。https://doi.org/10.6666/ClinMed.202103_87(3).0030
  4. Yu, C.Y., & Tseng, C. T. (2019). The use of systemic glucocorticoids in intensive care units. Journal of the Formosan Medical Association, 23(5).649 -657.https://doi.org/10.6320/FJM.201909_23(5).0011
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