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Chapter: Diseases of The Brain and Nervous System(A Health Education Guide): Neurological Medicines to be used for longer duration

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Steroids and Side Effects of Long Term Use

Steroids are used in some important, stubborn and acute diseases of neurology.

Steroids :

Steroids are used in some important, stubborn and acute diseases of neurology. These medicines are like a double-edged sword, i.e. if they are used in a proper way, in proper dose, for an appropriate period they give excellent results, save life and help in complete recovery from the disease which no other drug may be able to achieve. But if these drugs are taken inappropriately, in wrong doses without a doctor’s supervision for a long time, many serious problems can occur. The worst part is that these drugs have frequently been misused and abused instead of being appropriately used.

In fact, steroids are a group of endocrine hormones produced naturally in the adrenal gland with the help of vitamin C, e.g. corticosteroid, mineralo corticoids. Steroids play the major role in regulating the functions of the various glands, organs and systems of the body, development of immunity and fighting against stress. So, it can be comprehended that in the serious diseases occurring due to the defi of steroids, it is imperative to give synthetically prepared steroids. In neurology, appropriate use of steroids can give desired results in diseases ranging from low blood pressure to myasthenic crisis, cluster headaches to brain edema etc. In some neuropathies, demyelinating diseases (multiple sclerosis), brain tumor, polymyositis, some cases of T.B. meningitis, and many other diseases steroids are required.

The main steroids are prednisolone, dexamethasone, and methyl prednisolone. They are available in the form of tablets, injections or liquids. Abuse of these drugs can result in very serious consequences.

Side Effects of Long-Term Use, of Steroids :

1.        Acidity (burning sensation in stomach and chest) and ulcer formation or worsening of previous ulcers in the stomach.

2.        Increase in blood sugar and diabetes

3.        Increase in blood pressure

4.        Fungal infections occur rapidly resulting in candidiasis and ringworm infestation.

5.        Lipid abnormalities may occur

6.        Excessive hunger, insomnia, and irritabilityBloating of the body, excessive weight gain, and accumulation of fat on the face, stomach and back of the neck

7.        Difficulty in getting up from the floor due to weakness in muscles of waist

8.        Softening of the bones results in pain in vertebra and back

9.        Weakening of the hipbone causes pain and in some cases fractures may occur necessitating surgery

10.   Delayed wound healing

11.   Infections like T.B., herpes etc can be contracted easily

12.   Urinary infection

13.   Inflammation can occur in pancreas

14.   Potassium levels in blood may reduce, and

15.   BP may fall at an alarming rate due to abrupt withdrawal of steroids.

 

Because of all these reasons, steroids are prescribed in a high dose only for a few weeks. However, in some diseases very less result is seen on short-term administration of steroids and, therefore, they may have to be continued for a long period. In such cases regular advice from the doctor is essential. Supervision of a specialist with continuous laboratory monitoring is also important. In order to prevent the side effects of steroids (in long-term steroids course), the doctors regularly prescribe calcium, potassium, vitamins and diuretics (to prevent edema) in proper doses. Advice is given to protect the patient from infections. Proper guidance regarding diet is also provided. At regular intervals check - up for diabetes, calcium, blood potassium levels, blood pressure etc is done by the specialist and the patients should give full cooperation for the same.


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