Duration of Long Term Steroid Use

[oyyo]

---

Members don't see this ad.

Hello!

I am currently a P4 pharmacy student in an ER rotation - and a patient came in with Asthma exacerbation and was given prednisone therapy. My preceptor asked me if that would cause adrenal suppression and other nasty adverse effects - which i responded NO - as short term use (I said <2 weeks) is not associated with those side effects - which was correct.

Though on my way home - I was wondering how long would it take for chronic steroid use to actually start seeing those side effects - such as osteoporosis, diabetes, adrenal suppression? All the sources I looked at just says "prolonged use" - so I was wondering if anyone had any insight on this, and if there is a source behind when you actually start seeing these adverse effects.

Thank you in advance!

 

[Ackj]

Good question. I'm not certain about the osteoporosis, but the adrenal suppression is pretty quick, and the reason steroids are tapered if used for more than 10-14 days. The exact amount of time and degree of suppression is likely going to vary with patient and dose. Diabetes is hard to say. A single dose can give an elevated glucose level, but a non-diabetic patient isn't likely to have their glucose monitored anyway (aside from critical care). As we know, patients become insulin resistant over years, so it isn't likely to render a healthy patient diabetic. I would be more concerned about patients who are already pre-diabetic.

 

[Carboxide]

My general rule is that if there's a stop date, I'm not very worried about most stuff (adrenal suppression aside, which is ALWAYS a concern, but we pretty much always taper if it's > 3-4 days therapy).