Topical Corticosteroids
Treat PHOTOsensitivity reactions
As a hospital pharmacist, you will be asked more about how to treat photosensitivity reactions. Warmer weather will bring questions about photosensitizing medications. Photosensitivity reactions are due to a combination of UV light with a medication or metabolite in the skin and are hard to predict. Response varies and evidence is mostly from case reports. Be prepa…
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Steroids
Re-evaluate when SHORT-term steroid use is needed
New concerns will raise questions about when it's appropriate to use SHORT courses of oral corticosteroids in adults. We know long-term steroid use can lead to adverse effects, such as osteoporosis and weight gain . And using a steroid for just a few days can cause hyperglycemia , insomnia, etc. Now evidence links steroid use for just one week to a slightly high…
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Steroids
Give single dose dexamethasone for pediatric asthma exacerbations
More children will get just ONE or TWO doses of dexamethasone for asthma exacerbations. We're seeing a shift away from the typical 3- to 5-day course of prednisone or prednisolone to a 1- to 2-day course of dexamethasone. Dexamethasone is longer acting and may cause less vomiting. Plus new evidence suggests that a SINGLE dose of dexam…
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Steroids
Help patients stick with METHOTREXATE for rheumatoid arthritis
New guidelines will lead to questions about treating rheumatoid arthritis , especially with the plethora of medication options. For more information, see topic on Overview of rheumatoid arthritis . Which medication is first-line ? Recommend sticking with oral methotrexate 7.5 mg once weekly for most patients. Generally ad…
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Steroids
Consider using steroids for community acquired pneumonia (CAP) patients
As a clinical pharmacist, you'll see more push to use steroids for patients hospitalized with community-acquired pneumonia (CAP) . The thought is that inflammation in the lungs causes a lot of pneumonia symptoms. We've heard about this controversial topic for a while. Some small trials show a benefit, while others do not. To date, guidelines still don'…
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Steroids
Oral steroid instead of NSAIDs for ACUTE gout
Corticosteroids will be used more often for ACUTE gout flares. Oral corticosteroids work as well as NSAIDs for pain during a gout attack and are a safer choice for some patients. For further information, see note on " Comparison of gout therapies ". Consider a corticosteroid instead of an NSAID for mo…
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Steroids
Understanding the roles of remdesivir and dexamethasone for COVID-19
Remdesivir ( Veklury ) IS FDA-approved for all hospitalized COVID-19 patients who are at least 12 years old and weigh 40 kg or more. But this doesn't mean it should be used more. And conflicting guidelines add to the confusion. Be prepared to explain remdesivir's current role, especially compared to dexamethasone... In pa…
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Steroids
Identifying patients at risk for fractures due to chronic steroids
As a clinical pharmacist, it is important to address the therapy gap in preventing osteoporosis and fractures among patients on chronic corticosteroids. More than one in 10 patients using these medications long-term will experience a fracture as a result of glucocorticoid-induced osteoporosis. It is crucial for you as a pharmacist to be vigilant in identifying patien…
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