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[111] At low doses, breast tenderness has been reported in only 5% of women, but at high doses, it has been reported in up to 40% of women. [130] [63] Breast enlargement and tenderness may occur in 26% of women at high doses. [86] Some women regard spironolactone-induced breast enlargement as a positive effect. [64]
Cognitive symptoms from steroids appear within the first few weeks of treatment, appear to be dose dependent, and may or may not be accompanied by steroid psychosis or other Cushing's-type symptoms. [4] The symptoms include deficits in verbal and non-verbal memory; working memory; attention; sustained concentration; executive function ...
Methylprednisolone (Depo-Medrol, Medrol, Solu-Medrol) is a synthetic glucocorticoid, primarily prescribed for its anti-inflammatory and immunosuppressive effects. [4] [5] [6] It is either used at low doses for chronic illnesses or used concomitantly at high doses during acute flares.
If high doses were used for six to 10 days, reduce to replacement dose immediately and taper over four more days. Adrenal recovery can be assumed to occur within two to four weeks of completion of steroids. If high doses were used for 11–30 days, cut immediately to twice replacement, and then by 25% every four days.
To prevent steroid-induced osteoporosis, the steroid dose and duration should be as low and as short as possible. All patients on long term glucocorticoids (≥3 months) should be encouraged to do weightbearing exercise, avoid smoking and excess alcohol and take fall prevention measures. Daily calcium and vitamin d intake should be sufficient.
Prednisolone is a corticosteroid drug with predominant glucocorticoid and low mineralocorticoid activity, making it useful for the treatment of a wide range of inflammatory and autoimmune conditions [17] such as asthma, [18] uveitis, pyoderma gangrenosum, rheumatoid arthritis, urticaria, [19] angioedema, [19] ulcerative colitis, pericarditis ...
Rxn of the intermediate with the proton source leads to a dihydrobenzene; a special virtue of this sequence in steroids is the fact that the double bind at 2 is in effect becomes an enol ether moiety. Treatment of this product (2) with weak acid, oxalic acid for e.g., leads to the hydrolysis of the enol ether, producing β,γ-unconjugated ketone 3.
While the evidence for corticosteroids causing peptic ulceration is relatively poor except for high doses taken for over a month, [32] the majority of doctors as of 2010 still believe this is the case, and would consider protective prophylactic measures. [33] Eyes: chronic use may predispose to cataract and glaucoma.