Leicestershire Health Community
6 Endocrine system
- The CSM has issued a 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.
- To minimise long-term adverse effects use the lowest effective dose for the shortest possible time.
- Avoid abrupt withdrawal following long term therapy for 3 weeks or more. See BNF advice
- Steroid doses may need to be increased to cover the stress of acute illness or surgery. This is often overlooked and can result in serious illness and even death. BNF advice for patients undergoing surgery and recommendations from the Addison's Disease Self-Help group (ADSH) are available via the links below. The latter are also relevant to patients with hypopituitarism and those on supraphysiological doses of steroids (e.g. >5mg/day).
- Serious infections may be masked by corticosteroid therapy (e.g. septicaemia, tuberculosis); clinical presentation may be atypical.
- Suppressive therapy should not be given in infection without appropriate anti-infective agents