Steroids

Oral and injected corticosteroids (or simply steroids) are medications used to treat inflammation in the body. Indications: Used in Leukemia. Acute transplant rejection. Inflamatory conditaion of the skin. Used in the management of ulcerative collitius and chrons diesase. Poustral hypertension. Septic shock. Conginital adrenal hyperplasia. Used in the management of rasied intra cranial pressure. Hypersenstivity rection. Rheumatid arthritis. Sarcoidosis. Lupus erythematosus. Polyarthritis nodosa. Ashtma. Contraindications:
Pregnancy, Psychosis, Peptic ulcer disease. Osteoporosis. Renal failure. Congestive Heart Failure (CHF). Hypertension.

Diabetes. Epilepsy. Tuberculosis and other infections.

Uses of corticosteroids in dentistry Corticosteroid drugs have a wide range of uses in dentistry, including many in oral surgery. Steroids are used in intracanal medicaments such as Ledermix to reduce pulpal inflammation and are widely used in oral medicine such as in vesiculobullous diseases, orofacial granulomatosis, temporal arteritis and other oral mucosal disorders. Two recent applications have been the combination of hydrocortisone with oxytetracycline to prevent alveolar osteitis and the prevention of post-operative lingual and inferior alveolar nerve hypersensitivity following third molar extractions by using dexamethasone in conjunction with the analgesic agent dipyrone . Steroids are commonly used to limit post-operative inflammation. prevention of post-operative oedema and topical use on the lips and corners of the mouth to prevent ulceration and excoriation as a consequence of retraction during surgery. They are also used in the prophylaxis of adrenal crisis in patients with secondary adrenal insufficiency. Different steriods and their doses: Prednisolone: by mouth initally up to 10-20 mg(sever disease up to 60 mg daily) By im 25-100mg once or twice weekly. Betamethasone: by mouth 0.5 - 5 mg daily By im or slow iv or infusion 4-20mg repeted upto 4 times in 24 hrs Cortisone acetate: for replacement therapy 25-37.5 mg daily in divided doses. Deflazacort: usual maintenance 3-18 mg daily(acute disorders initally up to 120 mg daily) For child 0.25-1.5 mg/kg daily

Dexamethasone: by mouth 0.5-10 mg daily, child 10-100 micrograms/kg daily

Hydrocortisone: by mouth 20-30 mg daily in divided doses for child 10-30 mg By im or slow iv or infusion 100-500 mg 3-4 times in 24 hrs or as required Methylprednisolone: by mouth 2-40 mg daily By im or iv or infusion initally 10-500 mg; graft rejection up to 1g daily by intravenous infusion for up to 3 days Triamcinolone: by deep im injection into gluteal muscle 40 mg of acetonide for depot effects repeated at intervel according to the patients response max single dose 100mg

Side effects:
side effects are divided into long term side effect and short term side effects

Short-Term Side Effects of Systemic Steroids These may include an increase in appetite, difficulty sleeping (insomnia), changes in mood and behavior, flushing (redness) of the face, and short-term weight gain due to increased water retention. These side effects usually resolve after a few days once the steroids have been stopped.

Long-Term Side Effects of Systemic Steroids When systemic steroids are used for long periods of time, or when steroids are taken on multiple occasions, more serious side effects may occur. It is for these reasons that the dose and duration of systemic steroids should be minimized whenever possible. Some side effects can be decreased by taking systemic steroids every other day instead of daily, even if the total dose is the same. Many of the side effects are reversible if the steroids are stopped, while other side effects may be permanent. Side effects of long-term steroid use includes:

Glaucoma High blood pressure

Obesity Acid reflex/gerd Osteoprosis Myopathy Cataract Cushing syndrome

Refrence:
http://allergies.about.com/od/medicationinformation/a/systemicsteroid.htm https://dspace.gla.ac.uk/retrieve/575/license.txt http://ourmedmnemonics.blogspot.com/2010/01/22-contraindications-of-steroid.html http://www.ncbi.nlm.nih.gov/pubmed/8256457 bnf