{"id":9338,"date":"2021-12-19T00:25:23","date_gmt":"2021-12-18T22:25:23","guid":{"rendered":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/immunology\/steroid-treatment-indications-dose-of-equivalence-mechanism-of-action-side-effects-prevention\/"},"modified":"2021-12-25T17:52:01","modified_gmt":"2021-12-25T15:52:01","slug":"steroid-treatment-indications-dose-of-equivalence-mechanism-of-action-side-effects-prevention","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/immunology\/steroid-treatment-indications-dose-of-equivalence-mechanism-of-action-side-effects-prevention\/","title":{"rendered":"Steroid treatment (indications, dose of equivalence, mechanism of action, side effects, prevention)"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Corticosteroids were first used in patients with RA, dramatically improving their symptoms. They are used as first-line therapy to this day for a variety of inflammatory conditions.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>They can be used systemically (PO, IV) or locally (topical, intra-articular, epidural), and are available at different potencies.<\/li><li>In case of athritis in one or two joints, an intra-articular injection is a good choice of treatment to reduce the side-effects; in polyarthropathy, however, systemic administration is required.<\/li><\/ul>\n\n\n<span class=\"block-heading\" id=\"header_1\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Indications<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<p class=\"wp-block-paragraph\">Corticosteroids are indicated for usage in hundreds of conditions:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Inflammatory conditions<\/li><li>Allergic and autoimmune disorders<\/li><li>Shock<\/li><li>Treating hypercalcemia<\/li><li>Treating hypoglycemia<\/li><li>Hematological disorders<\/li><li>Corticosteroid replacement therapy<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Mechanism of action<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<p class=\"wp-block-paragraph\">Corticosteroids exert their actions by both acting as a transcription factor inducing anti-inflammatory genes, and by inactivating pro-inflammatory transcription factors. <\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Dose of equivalence<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<p class=\"wp-block-paragraph\">Doses of different steroids change according to their potency; to exert the same effect, more potent steroids require a smaller dose.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Short-acting, low potency<ul><li>Cortisone (25mg)<\/li><li>Cortisol (20mg)<\/li><\/ul><\/li><li>Medium-acting, medium potency<ul><li>Presnisolone (5mg)<\/li><li>Methylprednisolone (4mg)<\/li><li>Triamcinolone (4mg)<\/li><\/ul><\/li><li>Long-acting, high potency<ul><li>Dexamethasone (0.75mg)<\/li><li>Bethamethasone (0.75mg)<\/li><\/ul><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The doses written are the minimal doses that can be used for long-term therapy (months-indefinitely). They can be increased if the treatment is planned for a few days (for example, 250mg prednisone as bolus therapy).<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Adverse effects<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<ul class=\"wp-block-list\"><li>Fluid retention and edema<\/li><li>Hypertension<\/li><li>Osteoporosis<\/li><li>Gastric ulcers<\/li><li>Glaucoma<\/li><li>Diabetes<\/li><li>Myopathy<\/li><li>Psychosis<\/li><li>Infections<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Prevention of adverse effects<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<p class=\"wp-block-paragraph\">All adverse effects are reduced and may even reverse in discontinuation of the treatment.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Combination of other drugs (DMARDs) and reduction of the dose.<\/li><li>Cessation of smoking and alcohol consumption is helpful in many disorders.<\/li><li>Calcium and vitamin D supplementation, bisphosphanates (osteoporosis)<\/li><li>Moderate exercise (myopathy)<\/li><li>Lithium (psychosis)<\/li><li>PPIs (gastric ulcers)<\/li><li>Furosemide (fluid retention and HTN)<\/li><\/ul>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Indications<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Mechanism of action<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Dose of equivalence<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Adverse effects<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Prevention of adverse effects<\/h4><\/div>","protected":false},"excerpt":{"rendered":"<p>Corticosteroids were first used in patients with RA, dramatically improving their symptoms. They are used as first-line therapy to this day for a variety of inflammatory conditions. They can be used systemically (PO, IV) or locally (topical, intra-articular, epidural), and are available at different potencies. In case of athritis in one or two joints, an [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":9306,"menu_order":15,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-9338","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Steroid treatment (indications, dose of equivalence, mechanism of action, side effects, prevention) &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/immunology\/steroid-treatment-indications-dose-of-equivalence-mechanism-of-action-side-effects-prevention\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/immunology\\\/steroid-treatment-indications-dose-of-equivalence-mechanism-of-action-side-effects-prevention\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/clinical\\\/internal-medicine\\\/immunology\\\/steroid-treatment-indications-dose-of-equivalence-mechanism-of-action-side-effects-prevention\\\/\",\"name\":\"Steroid treatment (indications, dose of equivalence, mechanism of action, side effects, prevention) &#8211; 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