Oral steroids side effects
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Side Effects of Oral Steroids: A Comprehensive Overview
Behavioral Side Effects in Children with Asthma
Oral corticosteroids, commonly used to manage acute exacerbations of asthma in children, have been associated with significant behavioral side effects. A study comparing two doses of oral steroids (2 mg/kg vs. 1 mg/kg daily) found that higher doses were linked to increased anxiety and aggressive behavior. Specifically, anxiety and aggressive behavior were twice as common in children receiving the higher dose, with the number needed to harm being 6.1 for anxiety and 4.8 for aggressive behavior . This suggests that while both doses are effective in managing asthma symptoms, lower doses may be preferable to minimize adverse behavioral effects.
Ocular Complications
Oral steroids can also lead to ocular complications. Central serous chorioretinopathy, a condition affecting the retina, has been reported following the use of oral topical steroids . Additionally, systemic corticosteroids, including oral forms, have been associated with the development of cataracts and increased intraocular pressure, potentially leading to glaucoma . These findings highlight the importance of monitoring ocular health in patients undergoing steroid therapy.
Patient-Reported Side Effects
A survey involving over 1,200 asthma patients revealed a wide range of side effects from oral corticosteroids, impacting their quality of life. Commonly reported issues included agitation, poor sleep, and other symptoms not typically captured by existing questionnaires . This underscores the need for comprehensive tools to assess the full spectrum of steroid-induced side effects in clinical practice.
Systemic Effects: Bone Density and Adrenal Suppression
Long-term use of oral steroids can lead to serious systemic side effects such as osteoporosis and adrenal suppression. A comparative study found that daily oral steroid regimens significantly reduced bone mineral density and caused suprarenal suppression, whereas weekly oral pulse steroid regimens had a much lower impact on these parameters . This suggests that pulse therapy might be a safer alternative for long-term management of chronic conditions requiring steroids.
Anabolic Steroids: Risks and Side Effects
Anabolic-androgenic steroids (AAS), often abused for their muscle-building properties, carry significant risks. These include liver dysfunction, cardiovascular issues, and psychological effects such as mood swings and aggression Lamb1984Bond2022. Oral preparations of AAS are particularly associated with hepatotoxicity and other severe health risks, emphasizing the need for caution and medical supervision in their use.
Conclusion
Oral steroids, while effective for various medical conditions, come with a range of potential side effects. These include behavioral changes in children, ocular complications, systemic effects like osteoporosis and adrenal suppression, and significant risks associated with anabolic steroids. Clinicians should carefully weigh the benefits and risks, monitor patients closely, and consider alternative dosing regimens to minimize adverse effects.
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Most relevant research papers on this topic
Ocular complications of topical, peri-ocular, and systemic corticosteroids
Corticosteroids can cause ocular side effects, including cataract development and increased intraocular pressure, and should be advised of these risks when prescribing them.
A Review of the Effectiveness and Side-Effects of Fluocinolone Acetonide 0.1% in the Treatment of Oral Mucosal Diseases
Fluocinolone acetonide 0.1% effectively reduces pain, inflammation, and enhances lesion healing in oral mucosal diseases, with minor side-effects.
Management of the oral and maxillofacial surgery patient on anabolic steroids.
Anabolic steroids have potential side effects, including electrolyte disturbances, coagulopathies, hypertension, and dysrhythmias, and should be managed in oral and maxillofacial surgery patients.
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