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PEBC: What You Need to Know: Oral Corticosteroids

Examples: Dexamethasone, Prednisone, Prednisolone, Hydrocortisone, Fludrocortisone


Indications: (many!) to treat underlying inflammatory processes by suppressing the immune system, including asthma, COPD, pneumonia, allergic reaction, certain cancers, CINV, organ transplant etc...


Dosing: most can be dosed once daily in the morning (to reduce insomnia) and with food (to reduce upset stomach)

-doses may be divided for better tolerance


Adverse Effects: (too many!) adrenal suppression, increased blood glucose, increased blood pressure, dermal thinning, mood swings, insomnia, upset stomach, osteoporosis, glaucoma, cataracts, fluid retention, electrolyte imblances, weight gain, acne, growth suppression, GI bleed etc...


Drug Interactions:

-antidiabetic medications: steroids counter their glucose lowering effect

-most steroids are metabolized by CYP3A4, so caution with strong inhibitors and inducers

-increased risk of GI bleed with NSAIDs

-warfarin: steroids can increase warfarin effects

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