Side effects of oral steroids
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Side Effects of Oral Steroids
Oral steroids, commonly prescribed for various medical conditions, can have a range of side effects. These side effects can impact different systems in the body, including behavioral, ocular, metabolic, and psychiatric domains. This article synthesizes findings from multiple research studies to provide a comprehensive overview of the side effects associated with oral steroid use.
Behavioral Side Effects of Oral Steroids
One of the significant side effects of oral steroids, particularly in children, is the impact on behavior. A study comparing two doses of oral steroids (2 mg/kg vs. 1 mg/kg daily) in children with acute asthma exacerbations found that higher doses were associated with increased behavioral side effects. Specifically, anxiety and aggressive behavior were twice as common in patients receiving the higher dose. This suggests that while oral steroids are effective in managing asthma symptoms, careful consideration of the dosage is crucial to minimize adverse behavioral effects.
Ocular Side Effects of Oral Steroids
Oral steroids can also lead to ocular complications. Central serous chorioretinopathy, a condition affecting the retina, has been reported following the administration of oral topical steroids. Additionally, systemic corticosteroids, including oral forms, have been associated with the development of cataracts and increased intraocular pressure, which can lead to glaucoma. These findings highlight the importance of monitoring ocular health in patients undergoing steroid therapy.
Metabolic and Endocrine Side Effects
Long-term use of oral steroids can significantly impact metabolic and endocrine functions. A comparative study of daily versus weekly oral steroid regimens found that daily steroid use was associated with higher incidences of Cushingoid features, disturbed blood sugar levels, and suprarenal suppression. This indicates that alternative dosing regimens, such as weekly pulse therapy, may reduce some of these adverse effects.
Psychiatric Side Effects
Psychiatric symptoms are another serious concern with oral steroid use. A review of steroid-induced psychosis found that severe psychiatric symptoms occurred in approximately 5.7% of patients, with any psychiatric symptoms occurring in 18.6% of patients receiving high doses of prednisone. Symptoms can develop rapidly and include a range of psychiatric disorders such as mania, depression, and even psychosis. Early recognition and appropriate management, including the use of atypical antipsychotics, are essential for mitigating these effects.
Conclusion
Oral steroids, while effective for treating various conditions, come with a range of potential side effects. These include behavioral changes, ocular complications, metabolic disturbances, and psychiatric symptoms. Careful dosing, monitoring, and alternative treatment regimens can help mitigate some of these adverse effects. Clinicians should be vigilant in monitoring patients on oral steroids and provide appropriate interventions to manage side effects.
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