QuestionSBA
QuestionChoice
Prednisolone is a steroid medication used to reduce inflammation in rheumatological condition such as polymyalgia rheumatica. During sickness, patients are advised to increase the dose of prednisolone for two days before returning to the usual dose. This action aims to mimic the natural response of adrenal glands that increase the production of steroid hormones during illness
34090
a
She should double the dose of prednisolone during sickness
QuestionChoice
Prednisolone is not known to cause hypoglycaemia
34094
e
Prednisolone increases the risk of hypoglycaemia
QuestionChoice
Prednisolone could cause insomnia through the release of catecholamines. Hence, patients are usually advised to take prednisolone in the morning so that it does not keep them awake at night
34091
b
She should take prednisolone at night before sleeping
QuestionChoice
Dose of prednisolone needs to be reduced gradually before the treatment is stopped completely to reduce the risk of withdrawal symptoms
34092
c
She should immediately stop taking prednisolone once her symptoms have improved to reduce the risk of developing side effects
QuestionChoice
Peptic ulcer is a common side effect of all systemic corticosteroids
34093
d
Prednisolone decreases the risk of peptic ulcer
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2762
Steroid Sick Day Rule
Topic
9
Internal Medicine
6829
Case presentation: A 60-year-old woman attends the rheumatology clinic with a two-week history of fatigue and morning stiffness in the shoulder. She complains that the stiffness usually lasts more than 1 hour.  


Investigations:
 -ESR 45mm/hr [(age+10)/2]
 -CRP 20 mg/l (<10 )
A diagnosis of polymyalgia rheumatica is made and patient is advised to commence treatment with Prednisolone 10 mg PO daily.


Question: Select the most important information that should be provided for this patient.
a