Effects of prolonged use of oral corticosteroids

Corticosteroid is a hormone produced by the two adrenal glands secreted into the blood, has anti-inflammatory, anti-allergic and immunosuppressive effects.
Physiological effects on metabolism of protid, glucide, lipid, calcium, phosphorus, water and electrolyte metabolism. Accordingly, on organs and tissues such as the central nervous system, mood changes. On the digestive system, it increases the secretion of gastric acid and pepsin, causes appetite, reduces mucus secretion, on the heart, retains salt and water. Effects in treatment: Corticosteroids have three main effects: anti-allergic by blocking allergic reactions, anti-inflammatory (but only acting on the final stage of prostaglandin synthesis, unlike anti-inflammatory drugs). non-steroidal anti-inflammatory drugs) and immunosuppression leads to reduced resistance, making it easy to cause bacterial, fungal and viral infections. Therefore, corticosteroids are indicated in the treatment of a number of conditions such as adrenal insufficiency (replacement of hormone deficiency), inflammatory eye diseases, asthma, allergic rhinitis, atopic dermatitis, urticaria, Other allergies such as anaphylaxis,...

What are the harmful effects of taking corticosteroids? If taking corticosteroids for a long time, it can cause some unwanted effects such as adrenal insufficiency, weight gain due to salt and water retention, thin skin, increased blood pressure, diabetes,...

Using high dose and long-term corticosteroids will inhibit the growth of children's height. The reason is that corticosteroids inhibit the growth of bone and cartilage. To reduce the consequences of this condition should limit the use of corticosteroids in children. If necessary, use the lowest dose for the shortest time. When using corticosteroids for a long time, use high doses and alternate days. Supplement children with necessary foods, rich in protein and calcium.

The cause of osteoporosis is due to corticosteroids imbalance in bone formation and bone resorption, reducing calcium absorption in the small intestine. Overcoming osteoporosis by reducing the dose to the lowest level, reducing the duration of drug use, calcium and vitamin D supplementation, and estrogen replacement therapy for women in menopause.

The most important factor causing adrenal insufficiency is the duration of corticosteroid use. It also depends on the type of corticosteroid, the dose used and the route of absorption. Patients receiving low doses of corticosteroids for a prolonged period of several months still need to be tapered off slowly before discontinuing treatment. If corticosteroids are used for more than 2-3 weeks, a gradual dose reduction before discontinuation is imperative.

When using corticosteroids for a long time will cause Cushing's syndrome due to dysfunction of the adrenal cortex. Patients will have symptoms of muscle atrophy, skin atrophy, hirsutism, round face like the moon, ... In this case, it is necessary to stop the drug according to the rule of gradual dose reduction.

Gastric and duodenal ulcers are rarely associated with corticosteroid use, except in cases of high doses or in combination with non-steroidal anti-inflammatory drugs. Therefore, when corticosteroids are used alone, there is no need for prevention with H2
antihistamines.

Hyperglycemia is caused by glycogenolysis and the creation of sugar from protein. Long-term use of corticosteroids can lead to decreased glucose tolerance, decreased insulin response and increased risk of cardiovascular disease.

High dose corticosteroids cause water retention, sodium and potassium excretion leading to edema and myasthenia gravis.

Using topical corticosteroids such as topical application, eye drops, nose or spray, inhalation can also have undesirable effects such as systemic corticosteroids. In addition, topical medications cause skin thinning and skin atrophy. Therefore, the best way is to apply the right dose, in the right way and not on a large area of ​​the skin. Throat spray or inhalation can cause candida infection and difficulty speaking, so it is important to rinse your throat after spraying or inhaling the medicine.

Under normal physiological conditions, the concentration of corticosteroids in the human body's plasma changes according to the diurnal rhythm. Cortisol in the blood increases from 4 am, peaks at 8 am, then the amount of cortisol will gradually decrease, until 12 pm is the lowest and increases again about 4 am the next morning. So the adrenal glands stop working at night. If taking the drug in the evening, the adrenal gland will be suppressed all day, when this condition lasts for many days, it will cause adrenal cortex atrophy. Therefore, to avoid adrenal insufficiency when using corticosteroids for a long time, patients should only take them in the morning or take them every other day.
How to use corticosteroids with different dosage forms including:
Oral corticosteroids (tablets, syrups...): It is recommended to use corticoids with food to limit stomach irritation. Do not stop the drug suddenly if the patient has been taking corticosteroids for a long time. Because stopping the drug suddenly can cause serious, even life-threatening symptoms. Your doctor will show you how to slowly reduce your dose before stopping your corticosteroid treatment. Usually this process will take up to several weeks to give the body enough time to restore its natural hormone production. Topical corticosteroids or ointments used topically: Only a small amount of topical corticosteroids is used, enough to cover a thin layer of the affected skin. This will help prevent too much of the drug from being absorbed into the body and possibly causing unwanted effects. The affected area should not be bandaged after applying the medicine. Avoid applying to broken, non-healing skin or areas that are frequently rubbed. Inhaled corticosteroids: Inhaled corticosteroids usually do not cause serious side effects. However, some common undesirable effects such as oral thrush and hoarseness can be easily prevented by following the correct inhalation technique and rinsing the mouth after using the drug. Corticosteroids are a hormone produced by the two adrenal glands secreted into the blood, with anti-inflammatory, anti-allergic and immunosuppressive effects. However, long-term use of corticosteroids can cause some undesirable effects such as adrenal insufficiency, weight gain due to salt and water retention, thin skin, increased blood pressure, diabetes,... Therefore, Patients need to use the right medicine at the right dose, in the right route, at the right time and without stopping suddenly. Please consult your doctor about how to use corticosteroids and when there are abnormal signs, you need to go to a medical facility for timely medical examination and intervention.