Steroids

Corticosteroids are the drugs used for multifarious diseases because of their widespread action. It is suggested that these drug use should not be ceased rapidly, rather than it should be finished gently. Due to their diversity of actions and uses, more no of interactions with the drugs and diseases were recorded. It is well known that there is a strong relationship between corticosteroid use and psychiatric effects. Both the steroid induced psychiatric symptoms and diagnosis are uncertain. Hence Pharmacists are the best person to mould a suitable drug therapy and a management regimen for corticosteroids induced adverse events in patients. They can also play an important role in educating the patients about corticosteroids and their psychic disturbances. Since physicians do not take any interest in to alert the patients about the usage, interactions and highly severe psychiatric problems of steroids, the need of pharmacists becomes very important.

Steroids are widely prescribed in modern medicine, because steroid hormones are crucial for proper functioning of the body. Steroid prolonged use is associated with serious AEs. Hence this study was carried out to assess the prescribing pattern and appropriateness of steroids. A prospective observational study was conducted to analyze for the pattern of prescribed steroids and also analyzed to that of the recommended therapeutic guidelines. Out of 1084, 14.5% (157) were steroid therapy. Maximum use of steroids was prescribed for patients above 50 years of age. Almost 38.8% of reasons were related to RTI. The average number of drugs prescribed for each prescription was 9.82±3.7.  The drugs prescribed in the study population includes 13.29% of steroids and 54.1% were commonly given through nebulization at the time of admission and tablets was most common dosage form at the time of discharge. 2.5±8.23 average numbers of drug interactions, 21.66% had moderate drug interactions involving steroids. There were 4 adverse drug reactions observed and none of the steroids were involved in precipitating the ADRs.  As per therapeutic guidelines, 38.85% of steroids were inappropriately prescribed and Rs. 495±39.49 was the average cost increased (drugs cost alone) for patients for whom the steroids were inappropriately prescribed. This study may be concluded that use of therapeutic guidelines while prescribing corticosteroids will benefit the patients because of lesser side effects, and it also may reduce the cost of treatment and improve therapeutic outcome.

  Oral submucous fibrosis is a potentially malignant disorder with increased potential for malignant transformation. Major etiological factor for causation of OSMF is betel quid and gutka chewing habit. Patient with OSMF usually complains of burning sensation in the oral cavity and progressive difficulty in opening the mouth. Several management strategies have been tried in the treatment of OSMF and steroids are usually the mainstay of treatment for OSMF.  These case reports portray the etiology, clinical features and management of these cases.