Corticosteroids are likened to a double-edged sword, both edges being very sharp. Besides their therapeutic effects, corticosteroids can also cause dangerous side effects if used improperly or in incorrect dosages.
Adrenal Insufficiency, Diabetes, and Hypertension Due to Corticosteroid Abuse
Dr. Pham Thi Luu, a staff member at the Endocrinology Department of Bach Mai Hospital, noted that corticosteroid abuse is very common among patients treated at the facility. According to a survey, there was a time when the number of patients self-medicating with this type of drug accounted for up to 50% of inpatients in the Endocrinology Department. One of the very dangerous complications caused by the drug is adrenal insufficiency due to prolonged use of corticosteroids.
Dangerous side effects caused by corticosteroids
Pharmacist Nguyen Thi Thao, a lecturer at the Department of Pharmacology – Clinical Pharmacy at Hanoi University of Pharmacy, stated that in 2019, a research group from the Clinical Pharmacy Department collaborated with the Pharmacy Department of the Central Eye Hospital to conduct a survey on 827 patients regarding their habits of using eye drops. The research results showed:
- Over 18% of surveyed patients reported having used eye drops containing corticosteroids;
- Nearly 50% self-purchased the medication.
- 96% were unaware of any side effects associated with corticosteroid eye drops.
These alarming figures highlight the issue of corticosteroid abuse in the form of eye drops. Additionally, it is quite common for skin medications such as creams and ointments containing corticosteroids to be used for skin disorders, or for oral corticosteroids to be misused in treating upper respiratory symptoms (in cases of colds and flu).
“There are many reasons leading to corticosteroid abuse. The first reason is that corticosteroids have very strong anti-inflammatory effects. Patients notice an immediate reduction in symptoms after using the medication, leading them to think it is effective and therefore they prefer to use it. The second reason is the lack of proper awareness among the public regarding the use of this drug class. Most patients are aware of the therapeutic effects but not the potential side effects, even when used for short periods. The third reason is likely due to the fact that in our country, people can easily self-purchase these corticosteroid medications,” analyzed pharmacist Nguyen Thi Thao.
Patients Should Never Self-Medicate with Corticosteroids
Pharmacist Nguyen Thi Thao explained that corticosteroids are anti-inflammatory drugs commonly used to treat musculoskeletal diseases, autoimmune diseases, skin allergies, asthma, and adrenal insufficiency. This drug class is diverse, with many types and various brand names such as: Prednisone, Dexamethasone, Prednisolone, K-cort, Kenacort, Medrol, Polydexa, etc. Corticosteroids and medications containing corticosteroids are available in various forms such as tablets (oral use), inhalers, creams, gels, ointments (topical use), and nasal sprays.
Corticosteroids are often regarded by many as a “wonder drug” due to their rapid and potent anti-inflammatory effects. However, the abuse of this drug is quite common and can lead to serious complications for patients.
Corticosteroids are likened to a double-edged sword
For oral corticosteroid formulations, short-term use may cause mild discomfort such as increased appetite and insomnia. However, prolonged use at high doses can lead to serious side effects such as: Changes in appearance: a round face (Cushing’s syndrome) and weight gain. Thinning skin and easy bruising; Eye issues: cataracts, increased intraocular pressure; Immune system suppression, making patients more susceptible to infections; Cardiovascular problems, high blood pressure; Elevated blood sugar; Osteoporosis; Growth suppression in children. Notably, long-term corticosteroid use increases the risk of adrenal atrophy/failure.
Topical corticosteroids can cause skin thinning, redness, and acne in the treated area. Inhaled corticosteroids may also lead to side effects like oral thrush and hoarseness if not used correctly.
For patients with existing chronic diseases who abuse corticosteroids, this can worsen their condition, for example, increasing blood pressure and blood sugar levels, making the disease more difficult to manage.
According to pharmacist Nguyen Thi Thao, when using various corticosteroids, especially oral corticosteroids, patients should be vigilant for early signs of side effects and take timely action. Initially, patients may experience increased appetite, good eating, and difficulty sleeping. Then, one of the most noticeable signs is a round face. Those who are thin but suddenly have a round face, experience water retention, and a heavy feeling in the face, will eventually notice fat distribution in the shoulder area. Lipomas may bulge like buffalo humps, and the abdomen enlarges while arms and legs shrink, creating an appearance of being overweight but very unbalanced. In more severe cases, it can cause changes in hair, nails, and skin, such as women developing facial hair and increased body hair.
Therefore, when using corticosteroids as prescribed by a doctor (for treating a medical condition), if side effects occur, it is best for patients to inform their treating physician and not suddenly discontinue the medication. Abruptly stopping corticosteroids can lead to a flare-up of the medical condition. Furthermore, if a patient has been on high doses of corticosteroids for a long time, stopping the medication suddenly can lead to a very dangerous state of acute adrenal insufficiency.
“Corticosteroids have many side effects, some of which are easily identifiable, but others progress silently, only becoming apparent when complications arise, such as osteoporosis or cataracts. Therefore, patients undergoing corticosteroid treatment as prescribed by a doctor should also have regular check-ups according to the doctor’s schedule to allow for evaluation of side effects and management of these effects,” emphasized pharmacist Nguyen Thi Thao, who also advised patients against self-medicating with corticosteroids.
Safe and Rational Use of Corticosteroids
Pharmacist Nguyen Thi Thao advises that in cases where corticosteroids are used as prescribed by a doctor, it is essential to follow these guidelines to minimize side effects:
- Before treatment, inform your doctor about all medications you are taking and any existing medical conditions. Before long-term corticosteroid treatment, seek vaccination advice to prevent potential infections that may occur during corticosteroid use.
- During treatment, adhere to the prescribed medication regimen (including dosage and timing), and do not make any adjustments without consulting your doctor.
- Maintain a healthy diet (increase protein intake, limit carbohydrates, sugars, and fats), reduce salt intake, and supplement calcium.
- Quit smoking, limit alcohol consumption, and engage in regular physical activity.
- Regularly monitor signs and symptoms of drug side effects, and report any issues to healthcare staff during check-ups.
- Do not discontinue corticosteroids without your doctor’s permission.
- Avoid contact with individuals with infectious diseases such as shingles or chickenpox (if you have not been previously immunized).
Super Pig Population Explosion Spreading Across Canada
Sant’Antonio – The World’s First Underground Hydroelectric Power Plant
