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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Comparison
- Anti-inflammatory & immunosuppressive
- Same broad action drives the side effects
- Treats autoimmune, allergic, inflammatory disease
- ★Immunosuppression — ↑ infection, masks fever
- Replaces cortisol in adrenal insufficiency
- ★Abrupt stop then adrenal crisis — must taper
- Short courses limit metabolic impact
- Hyperglycemia, weight gain, moon face, Cushingoid
- Controls inflammatory arthritis flares
- Osteoporosis, fractures, muscle wasting
- Induces remission in IBD flares
- Peptic ulcers, GI bleed — take with food
- Mineralocorticoid support in Addison's
- Na⁺/fluid retention, edema, ↑ BP, ↓ K⁺
- Lowest effective dose, shortest duration
- Taper off
- monitor glucose, weight, infection, mood
Therapeutic Effect
- Anti-inflammatory & immunosuppressive
Adverse Effect
- Same broad action drives the side effects
Therapeutic Effect
- Treats autoimmune, allergic, inflammatory disease
Adverse Effect
- ★Immunosuppression — ↑ infection, masks fever
Therapeutic Effect
- Replaces cortisol in adrenal insufficiency
Adverse Effect
- ★Abrupt stop then adrenal crisis — must taper
Therapeutic Effect
- Short courses limit metabolic impact
Adverse Effect
- Hyperglycemia, weight gain, moon face, Cushingoid
Therapeutic Effect
- Controls inflammatory arthritis flares
Adverse Effect
- Osteoporosis, fractures, muscle wasting
Therapeutic Effect
- Induces remission in IBD flares
Adverse Effect
- Peptic ulcers, GI bleed — take with food
Therapeutic Effect
- Mineralocorticoid support in Addison's
Adverse Effect
- Na⁺/fluid retention, edema, ↑ BP, ↓ K⁺
Therapeutic Effect
- Lowest effective dose, shortest duration
Adverse Effect
- Taper off
- monitor glucose, weight, infection, 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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