Long-term corticosteroid therapy effects

Methotrexate is given weekly as an intramuscular injection of 15 to 25 mg. Side effects are rare and include leukopenia and hypersensitivity interstitial pneumonitis. Hepatic fibrosis is the most severe potential sequela of long-term therapy. Patients with concomitant alcohol abuse and/or morbid obesity are more likely to develop hepatic fibrosis and therefore should not be treated with methotrexate. It is prudent to obtain a baseline chest radiograph and to monitor complete blood count, liver function and renal function every two weeks until the patient is receiving oral therapy, and every one to three months thereafter. Before methotrexate therapy is initiated, the risks of treatment and the possible need for a liver biopsy should be discussed with the patient.

Ninety patients with giant cell arteritis were followed up 9-16 years (median years) after diagnosis. The mean duration of corticosteroid therapy was years (range 0- years). Together, the patients had received corticosteroids for 492 patient-years. Five years after diagnosis, 43% of the patients were on corticosteroid therapy. After 9 years, 15 of 60 surviving patients (25%) were still being treated with -10 mg of prednisolone daily (median dose 5 mg). The relapse rate was about 50%, regardless of the time after diagnosis, when an attempt to withdraw the treatment was made. Forty-six per cent of the relapses occurred within one month and 96% within one year of the end of treatment. Most of the flare-ups occurred during the first year of therapy and in 55% of the patients on a prednisolone dosage of 5 mg or less. We did not find any increase in morbidity in our patients compared to the general population. Nor did we see any significant complications which we could attribute to the steroid treatment.

Certain drugs such as troleandomycin (TAO), erythromycin ( Ery-Tab , EryPed 200), and clarithromycin ( Biaxin ) and ketoconazole ( Nizoral ) can reduce the ability of the liver to metabolize (breakdown) corticosteroids and this may lead to an increase in the levels and side effects of corticosteroids in the body. On the other hand, phenobarbital, ephedrine , phenytoin ( Dilantin ), and rifampin ( Rifadin , Rimactane ) may reduce the blood levels of corticosteroids by increasing the breakdown of corticosteroids by the liver. This may necessitate an increase of corticosteroid dose when they are used in combination with these drugs.

Healing from Plantar Fasciitis will take a commitment from you. You’ll need to commit to daily rest periods, icing, stretching and the daily wear of specialized orthotics. Some people find it hard to make the time or make the promise to themselves to do what they need to in order to recover. If you’re finding this a challenge, consider the fact that undertaking the work of treating your Plantar Fasciitis now at home could save you from having to take injections or undergo costly surgeries later. Your chances for recovery are extremely good, if you’re ready to make the commitment, and Heel That Pain is ready to help you, every step of the way .

Long-term corticosteroid therapy effects

long-term corticosteroid therapy effects

Healing from Plantar Fasciitis will take a commitment from you. You’ll need to commit to daily rest periods, icing, stretching and the daily wear of specialized orthotics. Some people find it hard to make the time or make the promise to themselves to do what they need to in order to recover. If you’re finding this a challenge, consider the fact that undertaking the work of treating your Plantar Fasciitis now at home could save you from having to take injections or undergo costly surgeries later. Your chances for recovery are extremely good, if you’re ready to make the commitment, and Heel That Pain is ready to help you, every step of the way .

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