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Corticosteroids may Aristocort canada Generic mask some signs of current infection. Special Pathogens Latent disease may be activated or there may be an exacerbation of intercurrent infections due to pathogens, including those caused by Amoeba, Candida, Cryptococcus, Mycobacterium, Nocardia, Pneumocystis, Toxoplasma.
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Similarly, corticosteroids should be used with great care onekhmer.org patients with Aristocort canada Generic or suspected Strongyloides threadworm infestation. In such patients, corticosteroid-induced immunosuppression may lead to Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal gram-negative septicemia.
Corticosteroids should not be used in cerebral malaria, Aristocort Canada Generic. Tuberculosis The use of corticosteroids in active tuberculosis should be restricted to those cases of fulminating or disseminated tuberculosis in which the corticosteroid is used for the management of the disease in conjunction with an appropriate antituberculous regimen. If corticosteroids are indicated in patients with latent tuberculosis or tuberculin reactivity, close observation is necessary as reactivation of the disease may occur.
During prolonged corticosteroid therapy, these patients should receive chemoprophylaxis. However, the response to such vaccines can not be predicted. Immunization procedures may be undertaken in patients who are Aristocort canada Generic corticosteroids as replacement therapy, e. Viral Infections Chicken pox and measles can have a more serious or even fatal course in pediatric and adult patients on corticosteroids. In pediatric and adult patients who have not had these diseases, particular care should be taken to avoid exposure. If exposed to chicken pox, Aristocort Canada Generic, prophylaxis with varicella zoster immune globulin VZIG may be Aristocort canada Generic. If exposed to measles, prophylaxis with immunoglobulin IG may be indicated. If chicken pox develops, treatment with Aristocort canada Generic agents should be considered.
The use of systemic corticosteroids is not recommended in the treatment of Aristocort canada Generic neuritis and may lead to an increase in the risk of new episodes. Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation. Corticosteroids should not be used in active ocular herpes simplex.
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Therefore, it should not be autoclaved when it is desirable to sterilize the exterior cheap Tenormin under treatment. When reduction in dosage is possible, the reduction should be gradual. Kaposi’s sarcoma has been reported to occur in patients Aristocort canada Generic corticosteroid therapy, Aristocort Canada Generic, most often for chronic conditions.
Discontinuation of corticosteroids may result in clinical improvement. Atrophy at the site of injection has been reported. Cardio-renal As sodium retention with resultant edema and potassium loss may occur in patients receiving corticosteroids, these agents should be used with caution in patients with congestive heart failure, hypertension, or renal insufficiency.
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Gastrointestinal Steroids should be used with caution in Aristocort canada Generic or Aristocort canada Generic peptic ulcer, Aristocort Canada Generic, diverticulitis, fresh intestinal anastomoses, and nonspecific ulcerative colitis, since they may the risk of a perforation.
Signs of peritoneal irritation following gastrointestinal perforation in patients receiving corticosteroids may be minimal or absent. There is an enhanced effect due to increased metabolism of corticosteroids in patients with cirrhosis. Appropriate examination of any Aristocort canada Generic fluid present is necessary to exclude a septic process. A marked increase in pain accompanied by local swelling, further restriction of joint motion, fever, and malaise are suggestive of septic arthritis. If this complication occurs and the diagnosis of sepsis is confirmed, appropriate antimicrobial therapy should be instituted. Injection of a steroid into an infected site is to be avoided. Local injection of a steroid into a previously infected joint is not usually recommended.
Musculoskeletal Corticosteroids decrease bone formation and increase bone resorption both through their effect on calcium regulation i.
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This, together with a decrease in the protein matrix of the bone secondary to an increase in protein catabolism, and reduced sex hormone production, may lead to inhibition of bone growth in Aristocort canada Generic patients and the development of osteoporosis at any age. Special consideration should be Aristocort canada Generic to patients at increased risk of osteoporosis i. The studies do Aristocort canada Generic that relatively high doses of corticosteroids are necessary to demonstrate a significant effect. An acute myopathy has been observed with the use of high doses of corticosteroids, most often occurring in patients with disorders of neuromuscular transmission e. This Aristocort canada Generic myopathy is tritonpipelining.com may involve ocular and respiratory muscles, and may result in quadriparesis, Aristocort Canada Generic.
Elevation of creatinine kinase may occur. Clinical improvement or Aristocort canada Generic after stopping corticosteroids may require weeks to years. Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids. Ophthalmic Intraocular pressure may become elevated in some individuals. If steroid therapy is continued for more than 6 weeks, intraocular pressure should be monitored.
Carcinogenesis, Mutagenesis, Impairment Of Fertility No Aristocort canada Generic studies have been conducted in animals to determine whether corticosteroids have a potential for carcinogenesis or mutagenesis. Steroids may increase or decrease motility and number of spermatozoa in some patients. Pregnancy Teratogenic Effects Pregnancy Category C Corticosteroids have been shown to be teratogenic in many species when given in doses equivalent to the human dose.
Animal studies in which corticosteroids have been given to pregnant mice, rats, and rabbits have yielded an increased incidence of cleft palate in the offspring. There are no Aristocort canada Generic and well-controlled studies in pregnant women. Corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Infants born to mothers who have received corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism.
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