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Visual disturbance may be reported with systemic and topical corticosteroid use. If a patient presents with symptoms such as blurred vision or other visual disturbances, the patient should be considered for referral to an ophthalmologist for evaluation of possible causes online payday loans may include cataract, glaucoma or rare diseases such as central serous chorioretinopathy (CSCR) which have been reported after use of systemic and topical corticosteroids.

Glucocorticoids can cause dose-related growth retardation in infancy, childhood and adolescence, which may be irreversible. Therefore, Dexamethasone should only be used in children with caution.

The common adverse effects of systemic glucocorticoids may be associated with more serious consequences in old age, especially osteoporosis, online payday loans, hypokalaemia, diabetes, susceptibility to infection and thinning of the payday loan online skin.

Close clinical supervision is required to avoid life-threatening reactions. Symptoms typically emerge within a few days or weeks of starting the treatment. Most reactions recover after either dose reduction or withdrawal, although specific treatment may be necessary. Particular care is required when considering the use of systemic corticosteroids in patients with existing or previous history of severe affective disorders in themselves or in their first degree relatives.

These would include depressive or manic-depressive illness and previous steroid psychosis. Preterm neonates: Available evidence suggests long-term neurodevelopment adverse events after early treatment (Rifampin, rifabutin, carbamazepine, phenobarbitone, phenytoin, primidone and aminoglutethimide enhance the metabolism of glucocorticoids and the therapeutic effects may be reduced.

Dexamethasone is a moderate inducer of CYP 3A4. Co-administration of dexamethasone with other drugs that are metabolized by CYP 3A4 (e. Co-treatment with CYP3A inhibitors, including cobicistat-containing products, is expected to increase the risk of systemic side-effects.

The combination should be avoided unless the benefit outweighs the increased risk of systemic corticosteroid side-effects, in which case patients should be monitored for systemic corticosteroid side-effects. The desired effects of hypoglycaemic agents (including insulin), antihypertensives and diuretics are antagonised by glucocorticoids.

Concurrent use of potassium-depleting diuretics (e. The efficacy of coumarin anticoagulants may be altered by concurrent glucocorticoid therapy and close monitoring of the International Normalised Ratio or prothrombin time is required. The renal clearance of salicylates is increased by glucocorticoids and steroid withdrawal may result in salicylate intoxication.

Combination of corticosteroids with ulcer-inducing agents (e. NSAID's) enhances the risk of peptic ulceration. Administration of corticosteroids to pregnant animals can cause abnormalities of foetal development including cleft palate, intrauterine growth retardation and effects on brain growth and development.

See also section 5. When administered for prolonged periods or repeatedly during pregnancy, systemic glucocorticoids increase the risk of intra-uterine growth retardation (IUGR). There is no evidence for an increased incidence of IUGR following short-term treatment, such as prophylactic treatment for neonatal respiratory distress syndrome.

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