Measures to reduce the side effects of Glucocorticoids

basic measures that should be performed routinely for patients receiving GCs to reduce the chance of an adverse reaction

  • • Prescribe corticosteroids at the lowest possible dose and taper the dose as soon as the disease activity permits.
  • • Encourage physical activities and avoid immobilization (helps prevent myopathy).
  • • Implement fall prevention program.
  • • Prescribe dietary and supplemental calcium to achieve intake of 1000 to 1500 mg/day.
  • • Supply vitamin D at a minimum of 1000 IU/day.
  • • Consider bisphosphonate therapy implementation (if >7.5 mg/day for >3 months) particularly if postmenopausal (see Chapter 52 : Metabolic Bone Disease).
  • • Document patient education concerning the adverse effects of therapy, particularly risk of osteonecrosis.
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