Notes for: Corticosteroids (Endocrine)Last edited [25/07/2012 15:11:40]
1. Patients receiving long term oral corticosteroids should be assessed for risk of long term side effects eg osteoporosis or steroid induced cataract.
2. Following concern about severe chickenpox associated with systemic corticosteroids, the CSM has issued notice that every patient prescribed a systemic corticosteroid should receive the patient information leaflet supplied by the manufacturer. Steroid treatment cards should also be issued where appropriate
3. Prednisolone is the standard glucocorticoid steroid. The link with peptic ulceration is weak and therefore e/c and soluble tablets are not recommended first line.
4. Soluble tablets are included for the treatment of acute asthma in children.
5. Dexamethasone has very high glucocorticoid activity and low mineralocorticoid activity and therefore is suited to treat those conditions where additional fluid retention or oedema may be a problem eg cerebral oedema.
6. Betamethasone soluble tablets may be used to formulate a topical mouthwash.
7. Methylprednisolone is used intra-venously for specific conditions requiring high dose, short term treatment.
Notes for: Use of CorticosteroidsLast edited [11/05/2012 11:58:06]
1. Equivalent doses of glucocorticoid activity:
5 mg Prednisolone =
Betamethasone 750 micrograms
Dexamethasone 750 micrograms
Hydrocortisone 20 mg
Methylprednisolone 4 mg
2. Different preparations of dexamethasone contain different salts. Therefore, care is needed to ensure that patients receive equivalent doses when transferring from tablets to injections. The equivalent doses are:
1 mg dexamethasone (tablets)
1.2 mg dexamethasone phosphate (injections)
1.3 mg dexamethasone sodium phosphate (injections and oral solutions).