Steroids are prescribed for a range of health conditions. In this podcast, which has been recorded for Chronic Conditions Month 2021, Dr Steve Holmes (Clinical Respiratory Lead for NHS Somserset) and Dr Kevin Fernando (GP Partner at North Berwick Health Centre and Education Director for GPnotebook Education) discuss the factors that primary care clinicians need to be aware of when prescribing these drugs. What are the most common side effects with steroid use? What do clinicians need to do to minimise the risk of adrenal crisis when withdrawing steroids? What should sick-day guidance look like for people on long-term steroid treatment? How vigilant do clinicians need to be for steroid-induced diabetes?
Kevin discusses what to do with each of the commonly used classes of diabetes drugs during intercurrent illness – a topic of particular relevance during the COVID-19 pandemic. Are these medications safe to continue? If so, is dose titration required? Which of these drugs be temporarily be stopped?
Kevin discusses some helpful and important clinical guidance on the prevention of adrenal crisis during the pandemic. Notably, this includes not only those patients with primary adrenal insufficiency but also all of those patients on long-term steroid treatment.
Dr Kevin Fernando provides a practical overview of the utility of sodium–glucose cotransporter 2 inhibitors, focusing on dosing, cardiovascular and renal safety and the management of adverse events, including dehydration and genital infections.
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