Corticosteroids adverse drug reaction

Adverse drug reactions drugs that can predispose to thrush include broad-spectrum antibiotics, corticosteroids and drugs that can affect oestrogen levels, including oral contraceptives, hormone replacement therapy, tamoxifen and raloxifene. 

Patients with chronic idiopathic urticaria, who develop cutaneous reactions in response to aspirin, display certain similarities in eicosanoid profile with AIA. The mechanism of the reactions is often related to COX-1 inhibition [18]. Therefore, aspirin and all drugs that inhibit COX-1 should be avoided in patients who already have had cutaneous reactions to NSAID. Coxibs are usually well tolerated, although occasional adverse reactions have been reported [19, 20]. For treatment of the reactions, antihistamines are usually sufficient, but in more severe cases adrenaline and corticosteroids may be warranted. 

Adverse reactions to sulfites appear to occur mainly among a small percentage of asthmatics, but it is possible for individuals without asthma to be sulfite sensitive. It is typically more of a problem in individuals with severe asthma who are also taking corticosteroid drugs to control their disease. Among these individuals, the prevalence of sulfite sensitivity is about 8%, while it is about 1% in asthmatics who are not dependent on steroids (Taylor and Bush, 1986). 

Drug interactions In a randomized, double-blind study, Zenapax or placebo was added to an immunosuppressive regimen of cyclosporine, mycophenolate mofetil, and steroids to assess tolerability, pharmacokinetics, and drug interactions. The addition of Zenapax did not result in an increased incidence of adverse events or a change in the types of adverse events reported. The following medications have been administered in clinical trials with Zenapax with no incremental increase in adverse reactions cyclosporine, mycophenolate mofetil, ganciclovir, acyclovir, azathioprine, and corticosteroids. 

Drug interactions No formal drug-drug interaction studies have been conducted. The following medications have been administered in clinical trials with Simulect with no incremental increase in adverse reactions azathioprine, corticosteroids, cyclosporine, mycophenolate mofetil, and muromonab-CD3. 

The nephrotic syndrome, characterized clinically by proteinuria, is a rare and idiosyncratic reaction to lithium. As with other uncommon adverse effects, the issue of causation versus coincidence must be considered. Treatment includes cessation of the drug and, when necessary, corticosteroids such as prednisone ( 322). 

Drug intolerance often limits the usefulness of agents used to treat IBD. Many patients receiving sulfasalazine, mesalamine, corticosteroids, metronidazole, azathioprine, mercaptopurine, or infliximab experience some undesired effects. In some cases, these adverse effects can be significant and require discontinuation of the therapy. Knowledge of the common or important adverse reactions will assist in avoiding or minimizing their effects. 

Corticosteroids also may be delivered by injection. The intramuscular route is preferable in patients with compliance problems, since a depot effect is achieved. Depot forms of corticosteroids include triamcinolone acetonide, triamcinolone hexacetonide, and methylprednisolone acetate. This provides the patient with 2 to 8 weeks of symptomatic control. The depot effect provides a physiologic taper, avoiding withdrawal reaction associated with hypothalamic-pituitary axis suppression. It should be noted that the onset of effect via this route may be delayed by several days. Intravenous corticosteroids may be used to provide the patient with large amounts of drug during a steroid burst to control severe symptoms. Intra-articular injections of depot forms of corticosteroids can be useful in treating synovitis and pain when a small number of joints are affected. The onset and duration of symptomatic relief are similar to those of intramuscular injection. The intra-articular route often is preferred because it is associated with the fewest number of systemic adverse effects. If efficacious, intra-articular injections may be repeated every 3 months. No one joint should be injected more than two to three times per year because of the risk of accelerated joint destruction and atrophy of tendons. Soft tissues such as tendons and bursae also may be injected. This may help control the pain and inflammation associated... 

Patients and physicians need to be aware that although antiasthma drugs inhaled from pMDIs do not usually produce adverse effects, they can make symptoms worse. Paradoxical bronchospasm has been associated with the use of betaj agonists and corticosteroids inhaled from MDIs (56-58). Decreases in FEVj, of more than 10% have been reported to occur in as many as 4.4% of subjects (59). Nick-las (58) reviewed adverse reaction reports submitted to the Center for Drug Evaluation and Research of the FDA between 1974 and 1988 of these, 126 reports associated with the use of these drugs by MDI, which were consistent with the diagnosis of paradoxical bronchospasm, were observed. More recently, Wilkinson et al. (60) reported paradoxical bronchoconstriction in asthmatic patients after inhaling salmeterol by a pMDI but not via a DPI. 

The skin lesion improved after the discontinuation of the ATDs and treatment with oral antihistamine and topical corticosteroid drugs. Streptomycin, Emb and ofloxacin were administered as second-line ATT during the patient s hospitalisation. No adverse reactions were observed. 

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