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

+ : 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

#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