Patient advice for administering acute oral steroids:

• Gastric ulceration
• Diabetes - sugar control
• Mania/insomnia

Steroid rules

Don't stop taking steroids suddenly

Sick day rules (double dose when ill)

Treatment card

Osteoporosis (bisphosonates given) if on long term steroids

PPI

Glucocorticoid side-effects

• endocrine
  • impaired glucose regulation
  • increased appetite/weight gain
  • hirsutism
  • hyperlipidaemia
• Cushing's syndrome
  • moon face
  • buffalo hump
  • striae
• musculoskeletal
  • osteoporosis
  • proximal myopathy
  • avascular necrosis of the femoral head
• immunosuppression
  • increased susceptibility to severe infection
  • reactivation of tuberculosis
• psychiatric
  • insomnia
  • mania
  • depression
  • psychosis
• gastrointestinal
  • peptic ulceration
  • acute pancreatitis
• ophthalmic
  • glaucoma
  • cataracts