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Indications:

Conditions amenable to systemic glucocorticoid therapy, esp for acute situations.

Contraindications:

Systemic therapy Peptic ulcers; systemic fungal infection; varicella & herpes genitalia infection; glaucoma. Local therapy Septic arthritis from gonorrhea or TB, instability of the joints. Hypersensitivity to glucocorticoids.

Adverse reactions:

GI disorders; skin atrophy, acne; psychic disturbances, convulsions; glaucoma, increased intraocular pressure, posterior subcapsular cataracts; fluid & electrolyte disturbances; Cushing-like syndrome, premature epiphyseal closure, menstrual irregularities; myopathy, abdominal distension, osteoporosis, aseptic necrosis of femoral & humeral heads; following IV inj of large doses, transient burning or tingling sensation.

Interactions:

Hypokalemia w/ diuretics &/or cardiac glycosides. Reduced effectiveness w/ rifampicin, ephedrine, barbiturates, phenytoin & primidone. Alters effects of oral anticoagulant. NSAIDs may increase severity of GI ulceration. Antidiabetic agents & active vaccines.

Warnings:

Latent or overt cardiac failure, renal dysfunction, HTN, epilepsy, migraine; history of psychotic illness; latent TB; incomplete statural growth; live vaccines. Pregnancy, lactation; osteoporosis. Pregnancy: Hypokalemia w/ diuretics &/or cardiac glycosides. Reduced effectiveness w/ rifampicin, ephedrine, barbiturates, phenytoin & primidone. Alters effects of oral anticoagulant. NSAIDs may increase severity of GI ulceration. Antidiabetic agents & active vaccines. Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

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