A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Cortone Side Effects, and Drug Interactions - Cortisone Acetate
Cortone Side Effects, and Drug Interactions - Cortisone Acetate
SIDE EFFECTS
Fluid and electrolyte disturbances
Sodium retention
Potassium loss
Fluid retention
Hypokalemic alkalosis
Congestive heart failure in susceptible patients
Hypertension
Musculoskeletal
Muscle weakness
Vertebral compression fractures
Steroid myopathy
Aseptic necrosis of femoral and humeral heads
Loss of muscle mass
Osteoporosis
Tendon rupture, particularly of the Achilles tendon
Pathologic fracture of long bones
Gastrointestinal
Peptic ulcer with possible perforation and hemorrhage
Abdominal distention
Ulcerative esophagitis
Pancreatitis
Increases in alanine transaminase (ALT, SGPT), aspartate transaminase (AST, SGOT) and alkaline phosphatase have been observed following corticosteroid treatment. These changes are usually small, not associated with any clinical syndrome and are reversible upon discontinuation.
Dermatologic
Impaired wound healing
Facial erythema
Thin fragile skin
Increased sweating
Petechiae and ecchymoses
May suppress reactions to skin tests
Neurological
Increased intracranial pressure with papil-ledema (pseudotumor cerebri) usually after treatment
Convulsions
Vertigo
Headache
Endocrine
Menstrual irregularities
Suppression of growth in children
Development of Cushingoid state
Decreased carbohydrate tolerance
Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
Manifestations of latent diabetes mellitus Increased requirements for insulin or oral hypoglycemic agents in diabetics
Ophthalmic
Posterior subcapsular cataracts Glaucoma
Increased intraocular pressure Exophthalmos
Metabolic
Negative nitrogen balance due to protein catabolism
DRUG INTERACTIONS
The pharmacokinetic interactions listed below are potentially clinically important. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of corticosteroids and may require increases in corticosteroid dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of corticosteroids and thus decrease their clearance. Therefore, the dose of corticosteroid should be titrated to avoid steroid toxicity. Corticosteroids may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when corticosteroid is withdrawn. Aspirin should be used cautiously in conjunction with cortico-steroids in patients suffering from hypopro-thrombinemia. The effect of corticosteroids on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulants when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.
top
