21 Nov 2023 • Doctors, take a look at this case

A 40 year old male began to notice rapid weight gain (7 - 8 kg) in the past 4 months along with progressive difficulty in walking.

Physical Examination revealed abdominal striae, edema over legs and fatigue😪

On further probing, we found that the patient had been self administering Prednisolone 20 mg per day and NSAIDS for chronic low backache since 3 years💊

So who's the culprit?!🤷‍♀️

STEROIDS

To be precise, the Lack of Steroid Stewardship was the culprit🤦‍♀️

So what is Steroid Stewardship?

The systematic effort of judiciously prescribing and monitoring glucocorticoids to patients, taking into account both their potential benefits and risks, is the essence of Steroid Stewardship✅

Let's take a look at the components of Steroid Stewardship:

• Pre-prescription screening
• Rational prescription
• Medical care during steroid use
• Appropriate monitoring after the steroids have been discontinued.

As clinicians, we need to make sure about the indication and aim of steroid prescription to our patients. But how?

Use BLACK❗️

• Benefits
• Limitations
• (possible) Adverse events
• Cost
• Knowledge/skills required to use steroid

Steroid stewardship adds value to glucocorticoid use and we need to ensure rational and effective use of these life-saving drugs.

There are more mnemonics like the 4Cs and the 5Ds, which we can use to ensure seamless management and establish effective Steroid Stewardship.

🔗Click here to catch more on the Prudent use of steroids from Dr. Bantwal, right here on Medflix.