Which considerations are appropriate for systemic corticosteroids?

• A. Monitor blood glucose and infection risk; assess GI protection and taper dosing when indicated
• B. Monitor liver enzymes only
• C. Avoid monitoring altogether
• D. Increase electrolyte intake only

Answer: (A)

Systemic corticosteroids affect metabolism, immune function, and the gastrointestinal tract, so careful monitoring targets several key risks. They commonly raise blood glucose, so watching glucose levels is important, especially in patients with diabetes or impaired glucose tolerance. They suppress immune responses, increasing infection risk, so clinicians stay vigilant for fever, new or worsening infections, and wound healing issues. Long-term or high-dose use can irritate the stomach and increase the risk of ulcers or bleeding, particularly when NSAIDs or other irritants are used, so assessing the need for GI protection (such as a proton pump inhibitor or H2 blocker) is prudent and tapering the dose when indicated helps prevent withdrawal and adrenal suppression.

Choosing only liver enzymes or electrolyte intake misses these major concerns, and avoiding monitoring altogether would leave patients vulnerable to adverse effects.