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Chapter-098 Corticosteroids

BOOK TITLE: Ramamurthy's Decision Making in Pain Management: An Algorithmic Approach

Author
1. KM von Kriegenbergh
ISBN
9789386261458
DOI
10.5005/jp/books/14128_99
Edition
3/e
Publishing Year
2018
Pages
2
Author Affiliations
1. Texas Tech University Health Sciences Center, Lubbock, TX, USA
Chapter keywords
Corticosteroids, anti-inflammatory, chronic oral steroid, gastric bleeding, osteoporosis, endocrine disorder, epidural steroid, intrathecal steroid

Abstract

Corticosteroids are used for anti-inflammatory and membrane stabilizing properties in the management of pain. Inhibition of the phospholipase A2 enzyme decreases the concentration of arachidonic acid metabolites—leukotrienes, thromboxanes, prosta-glandins, and prostacyclins, ultimately leading to decreased inflammation. The short-lived membrane stabilizing effect on nociceptive C fibers prevent ectopic discharge from injured nerve segments and result in a transient break in efferent pain pathways. Side effects of chronic oral steroid use include immu-nosuppression, gastric bleeding, fluid and electrolyte imbalances, musculoskeletal problems manifesting as osteoporosis and fractures, and endocrine disorders including cushingoid features and blood sugar derangements.

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