Anti-inflammatory steroids adverse effects

Intranasal corticosteroids are the most effective anti-inflammatory agents used in pediatric patients with allergic rhinitis. Although fewer studies have been conducted in children, results demonstrate that intranasal corticosteroids are effective and well tolerated, with an adverse-effect profile similar to placebo. Mometasone is indicated for children as young as 2 years of age, fluticasone is indicated for children 4 years of age and older, and beclomethasone, budesonide, flunisolide, and triamcinolone are indicated for children 6 years and older.15 Because concerns regarding effect of intranasal steroids on growth exist, the growth of pediatric patients prescribed intranasal steroids should be monitored routinely via stadiometry. 

Wynne HA, Long A. Patient awareness of the adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs). Br J Clin Pharmacol 1996 42(2) 253-6. 

Non-steroidal anti-inflammatory agents used to reduce fever and other aldesleukin adverse effects can theoretically potentiate aldesleukin nephrotoxicity by inhibiting prostaglandin synthesis. However this effect was deemed unhkely by several authors (85). 

A literature review has provided reassurance about the relative safety of spinal manipulation (142). When the serious adverse effects of non-steroidal anti-inflammatory drugs were compared with those of spinal manipulation, both used for neck pain, manipulation emerged as being safer by more than two orders of magnitude. However, these procedures can be associated with serious complications, particularly when they involve the cervical spine (143). 

Wilholm BE, Myrhed M, Ekmau E. Trends and patterns in adverse drug reactions to non-steroidal anti-inflammatory drugs reported in Sweden. In Rainsford KD, Velo GP, editors. Side-effects of Anti-inflammatory Drugs, Part I. Clinical and Epidemiological Aspects. Lancaster MTP Press, 1987 55. 

The most common adverse effect of phenol injection is pain during injection, often described as a burning or stinging sensation. It can be associated with edema several hours after injection. The apphcation of ice and the use of non-steroidal anti-inflammatory drugs often help to minimize the discomfort. In some studies, lidocaine mixed with phenol has been used to help diminish the local pain response associated with injection (21). 

Tramadol and non-steroidal anti-inflammatory drugs have been compared in two studies of patients with joint pain associated with osteoarthritis (8,9). In an open, randomized study 60 patients with osteoarthritis taking NSAIDs were given either modified-release tramadol 100 mg 8-hourly or modified-release dihydrocodeine 60 mg 8-hourly for 4 days the controls were 30 patients who took an NSAID alone (8). Both opioids provided adequate analgesic adjuncts to NSAIDs, but tramadol caused significantly more minor initial adverse effects. 

Adverse effects of antimicrobials are treated with antihistamines (Benadryl), epinephrine (adrenalin), and steroids for anti-inflammatory response. 

Adverse drug reactions drugs that can produce cough as a side-effect include angiotensin-converting enzyme inhibitors, non-steroidal anti-inflammatory drugs and beta-blockers. 

In another survey conducted by the clinical section of the British Pharmacological Society over a one-year period from 1986 to 1987, 8163 healthy volunteers received drugs for research purposes.Potentially life-threatening adverse effects were reported in 0-04% and moderately severe adverse effects in 0-55%, with no lasting sequelae. The three severe reactions were skin irritation and rash requiring hospitalisation, anaphylactic shock after an oral vaccine, and perforation of a duodenal ulcer after multiple-dose non-steroidal anti-inflammatory drug all made a complete recovery. The results were similar to those reported in the earlier ABPI survey and the authors concluded that the risk involved in these studies is very small... 

Almost three decades ago, steroids namely prednisolone, dexamethasone, betamethasone, triamcinoline and hydrocortisone were considered to be the dmg of choice as anti-inflammatory agents. Owing to the several adverse effects caused by either short-term or long-term steroid therapy, these have been more or less replaced by much safer and better tolerated non-steroidal anti-inflammatory drugs (NSAIDs). 

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