Corticosteroid Effects: Therapeutic vs Adverse — The Same Drug, Two Faces
Every therapeutic effect of prednisone has a dark mirror image at higher doses or longer duration. The NCLEX exploits this — the same mechanism that resolves inflammation also causes Cushing's features, hyperglycemia, and adrenal suppression. Confusing desired effects with adverse ones means missing critical teaching or, worse, abruptly stopping the drug.
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- Suppresses inflammation & immunity
- Risk rises with dose + duration
- Treats autoimmune & allergic disease
- ★↑ Infection risk, masks fever
- Replaces cortisol in adrenal insufficiency
- ★Abrupt stop: adrenal crisis
- Stimulates appetite (palliative care)
- Hyperglycemia
- Moon face, central obesity
- Controls inflammatory arthritis flares
- Osteoporosis, fractures, muscle wasting
- Induces remission in IBD flares
- Peptic ulcer, GI bleed risk
- Mineralocorticoid support in Addison's
- Na⁺/fluid retention, edema, ↑ BP, ↓ K⁺
- Lowest effective dose, shortest duration
- Monitor glucose, weight, mood
Therapeutic Effect
- Suppresses inflammation & immunity
Adverse Effect
- Risk rises with dose + duration
Therapeutic Effect
- Treats autoimmune & allergic disease
Adverse Effect
- ★↑ Infection risk, masks fever
Therapeutic Effect
- Replaces cortisol in adrenal insufficiency
Adverse Effect
- ★Abrupt stop: adrenal crisis
Therapeutic Effect
- Stimulates appetite (palliative care)
Adverse Effect
- Hyperglycemia
- Moon face, central obesity
Therapeutic Effect
- Controls inflammatory arthritis flares
Adverse Effect
- Osteoporosis, fractures, muscle wasting
Therapeutic Effect
- Induces remission in IBD flares
Adverse Effect
- Peptic ulcer, GI bleed risk
Therapeutic Effect
- Mineralocorticoid support in Addison's
Adverse Effect
- Na⁺/fluid retention, edema, ↑ BP, ↓ K⁺
Therapeutic Effect
- Lowest effective dose, shortest duration
Adverse Effect
- Monitor glucose, weight, mood
★ marks the fact that sets a column apart.
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Short-term hero, long-term Cushing's — same drug, same mechanism, different duration. Never stop abruptly.
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