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Fluid and electrolyte disturbances

Sodium retention

Potassium loss

Fluid retention

Hypokalemic alkalosis

Congestive heart failure in susceptible patients

Hypertension

Musculoskeletal

Muscle weakness

Vertebral compression fractures

Steroid myopathy

Aseptic necrosis of femoral and humeral heads

Loss of muscle mass

Osteoporosis

Tendon rupture, particularly of the Achilles tendon

Pathologic fracture of long bones

Gastrointestinal

Peptic ulcer with possible perforation and hemorrhage

Abdominal distention

Ulcerative esophagitis

Pancreatitis

Increases in alanine transaminase (ALT, SGPT), aspartate transaminase (AST, SGOT) and alkaline phosphatase have been observed following corticosteroid treatment. These changes are usually small, not associated with any clinical syndrome and are reversible upon discontinuation.

Dermatologic

Impaired wound healing

Facial erythema

Thin fragile skin

Increased sweating

Petechiae and ecchymoses

May suppress reactions to skin tests

Neurological

Increased intracranial pressure with papil-ledema (pseudotumor cerebri) usually after treatment

Convulsions

Vertigo

Headache

Endocrine

Menstrual irregularities

Suppression of growth in children

Development of Cushingoid state

Decreased carbohydrate tolerance

Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness

Manifestations of latent diabetes mellitus Increased requirements for insulin or oral hypoglycemic agents in diabetics

Ophthalmic

Posterior subcapsular cataracts Glaucoma

Increased intraocular pressure Exophthalmos

Metabolic

Negative nitrogen balance due to protein catabolism