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Since everyone is suddenly VERY INTERESTED in steroid side effects 
, here is a 
of the ones that your preceptors would likely expect you to be aware of as a #pharmacystudent.
1/11
, here is a of the ones that your preceptors would likely expect you to be aware of as a #pharmacystudent.1/11
+ 
: Mood and sleep disturbances. Sometimes psychosis, which is getting all the attention rn, but minor changes - like irritability - are more common.
: Hypertension as a long-term side effect. Hypotension as a short-term side effect during / immediately after an IV dose.
: Immunosuppression / increased risk of infection / altered response to vaccines.It’s a topic worthy of a
of its own, but 
for #pharmacystudents on a #PedsPharm rotation is to double-check 
CDC guidance on vaccine schedules 
and steroids.3/11
: Hypothalamic-pituitary-adrenal (HPA) suppression. Another topic worthy of its own
, but for #pharmacystudents is to remember steroid tapers are as much art 
as science 
, so go ahead and calculate 
the “ideal” regimen, but then ROUND IT to something measurable.
: Myopathy.
: Osteopenia / osteoporosis as a long-term side effect. In the peds lupus clinic, bone health is the most common topic Grace and I review with patients! We talk about weight-bearing exercise
, calcium-rich foods / calcium supplements 
, and vitamin D 
.
: Blurred vision, cataracts, glaucoma.
: Impaired glucose metabolism, insulin resistance, beta cell dysfunction.
: Fluid retention, edema.6/11
: GI upset, or worse, gastric ulcers. Concomitant NSAIDs may increase the risk, and H2 antagonists are sometimes added as a protective measure. ( #TwitteRx could probably have a very long, heated debate about this topic... )7/11
: I’m intentionally not talking about topical steroids in detail, because there is already a great out there, but!!!An ADE + counseling point that I often see #pharmacystudents forget: Steroids cause thinning of the skin. Apply as a THIN layer. https://twitter.com/drsteventchen/status/1123605778127052800?s=21
Leukocytosis. There’s an interesting here: https://twitter.com/tony_breu/status/1053671032140251136?s=21
And if you’re a #pharmacyresident on a #specialtypharmacy learning experience, you might want to know more about steroids and eosinophils specifically. There’s an amazing here: https://twitter.com/avrahamcoopermd/status/1304825763984703489?s=21
here: https://twitter.com/avrahamcoopermd/status/1304825763984703489?s=21
#TwitteRx please chime in 
if I missed something super interesting or specific to a certain patient population!
And quick study tips:
Draw a stick figure and write in ADEs over corresponding body parts / organ systems.
Listing them head to toe used to help me!
11/11
if I missed something super interesting or specific to a certain patient population!And quick study tips:
Draw a stick figure and write in ADEs over corresponding body parts / organ systems. Listing them head to toe used to help me!11/11
