SYSTEMIC STEROIDS
Systemic steroids are usually reserved for severe symptoms that do not | respond to other medications or for patients who cannot tolerate other ' drugs. In these cases, your physician may treat you with either oral or | injected systemic corticosteroids. Treatment regimens include either a preseasonal intramuscular injection or oral corticosteroids, administered j for a week to several weeks. For patients with severe allergies and asthma, - I long-term steroids may be necessary.
Side Effects
Systemic corticosteroid effects include adrenal suppression if used for more than 2 weeks. A short-term course of steroids may cause mood 1 swings (especially for children) and increased hunger. Even a short - I term course can lead to a lowering of the body’s resistance to chicken - I pox, if you have not been exposed to this disease. Contact your doctor 1 if you or your child are taking (or have just finished) oral steroids and 1 come into contact with chickenpox. If your doctor thinks you are at | risk he or she can give you an injection to protect you.
Long-term steroid administration (months or years) can have seri - j ous side effects. For these reasons your doctor should always try to pre - ) scribe the smallest possible dose. It is important that you continue all other treatments and take them regularly to keep the need for oral steroids to a minimum. The side effects of long-term oral steroid use include flattened face (moon face), feeling hungry and wanting to eat more (leading to weight gain), water retention, feeling hyped up and
overactive, difficulty sleeping (although patients report that they don’t feel tired), feeling depressed or experiencing sudden mood swings, heartburn and indigestion, bruising easily, brittle bones (osteoporosis), altering diabetic control or uncovering a tendency to diabetes, increased risk of cataract, and worsening of glaucoma.
Taking your steroids in the morning may decrease any side effects. Weight-bearing exercise, such as walking for 20 minutes each day will help protect against the bone thinning effect of long-term steroid use. Hormone-replacement therapy (HRT) in postmenopausal women reduces the risk of bone thinning and is advised in postmenopausal woman on long-term steroids. Continue taking topical nasal steroid sprays as this may decrease the need in dose or time for you to take oral steroids.
When you are taking oral steroids your adrenal gland becomes lazy and makes less of its own natural steroids. This means you have less ability to cope with infections or deal with physical stress. Long courses of steroids (3 weeks or more) can be stopped only by gradual reduction and under the guidance of a doctor. If they are stopped suddenly, you will be very vulnerable to infection and less able to cope with any crisis, such as an operation. For this reason, the doses should be reduced slowly over weeks or months.
Two oral agents are prednisone (Deltasone) and methylprednisolone (Medrol). An injectable steroid is triamcinolone (Aristocort).
