Corticosteroids. Study participants may receive corticosteroid(s) for mitigation of COPD exacerbations. The treating physician will determine medication regimen and instruct study participants on appropriate use.
Corticosteroids. Corticosteroids, or steroids, also possess anti-inflammatory properties and are commonly used in the practice of pain management, either systemically or locally, depending on the condition. Steroids work by decreasing inflammation and reducing the activity of the immune system. While steroids are commonly used, they may have numerous and serious side effects. These side effects may include allergic or hypersensitivity reactions, increased risk for infection, adrenal insufficiency, diabetes or decreased glucose tolerance, hypertension, loss of bone density, and loss of joint cartilage volume. In addition, steroids should not be administered when there is an infection present because steroids can inhibit the body’s natural infection-fighting immune response. Also, if a joint is already damaged or is subject to chronic deterioration, intra-articular, or IA steroid injections are not likely to provide any long-term restorative benefit. For the above reasons, IA steroid injections are generally recommended to be administered no more often than every six weeks and not more than three to four times per year.
Corticosteroids. Steroids have a powerful anti-inflammatory effect and are one of the quickest acting drugs used in RA. They are often used early in disease in combination with DMARDs which have a slower onset of action and are commonly used to rapidly suppress inflammation if disease flares. The main problem which limits their use is the well documented side effects associated with prolonged use. These include cataracts, adrenal suppression, hypertension, fluid retention, musculoskeletal (osteoporosis, myopathy and avascular necrosis) and metabolic (diabetes, hyperlipidaemia and obesity) effects.
Corticosteroids. Systemic corticosteroids are frequently given during premature labour to enhance foetal lung development. There have been reports of pulmonary oedema in women concomitantly administered with beta-agonists and corticosteroids. Corticosteroids are known to increase blood glucose and can deplete serum potassium, therefore concomitant administration should be undertaken with caution with continuous patient monitoring owing to the increased risk of hyperglycaemia and hypokalaemia (see section 4.4). The administration of beta-agonists is associated with a rise of blood glucose, which can be interpreted as an attenuation of anti-diabetic therapy; therefore individual anti-diabetic therapy may need to be adjusted (see section 4.4). Owing to the hypokalaemic effect of beta-agonists, concurrent administration of serum potassium depleting agents known to exacerbate the risk of hypokalaemia, such as diuretics, digoxin, methyl xanthines and corticosteroids, should be administered cautiously after careful evaluation of the benefits and risks with special regard to the increased risk of cardiac arrhythmias arising as a result of hypokalaemia (see section 4.4).
Corticosteroids. Prednisolone can cross the placenta, thus potentially exposing the foetus to adverse effects of the drug. (189) The major foetal risks regarding steroids are cleft palate (particularly with high dose exposure in the first trimester), premature rupture of the membranes and intrauterine growth restriction. (IUGR) (190, 191) Reports of low birth weight and IUGR associated with steroid usage during pregnancy are confounded by the severity of underlying disease necessitating corticosteroid therapy. In addition, foetal adrenal hypoplasia and suppression of the foetal pituitary have also been described, although both are uncommon due to the rapid maternal metabolism and placental breakdown of corticosteroids. Prednisolone is considered a class B drug in terms of its risk for pregnancy by the FDA. Overall, it is generally accepted amongst experts that maintenance of graft tolerance and prevention of rejection is crucial and that risks associated with steroids are outweighed by the benefit of good disease control. Thus, any maintenance prednisolone should be continued throughout pregnancy.
