28 Jun 2023
41m

#129 Steroids: 5 Pearls Segment

Podcast cover

Core IM | Internal Medicine Podcast

The podcast addresses the use of corticosteroids, exploring the principles for choosing specific types, managing side effects, and appropriate weaning strategies. It emphasizes three guiding principles: glucocorticoid activity, mineralocorticoid activity, and half-life/potency, using the mnemonic "high-powered MD" (hydrocortisone to dexamethasone) to illustrate the spectrum. The discussion highlights the importance of considering individual patient factors and potential risks, such as avascular necrosis and infection, even with short-term use. Prophylactic measures like PJP, GI ulcer, and osteoporosis prophylaxis are reviewed, with timelines for implementation. The podcast underscores the art of steroid tapering, advocating for a gradual approach, especially below 20mg prednisone equivalent, and awareness of adrenal insufficiency and steroid withdrawal symptoms.

Outlines

Part 1: Introduction, Basics

Part 2: Steroid Selection, Pharmacology

Part 3: Risks, Side Effects

Part 4: Prophylaxis, Prevention

Part 5: Tapering, Weaning

Part 6: Conclusion

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