is known that antacids can decrease the amount of glucocorticoids absorbed, especially
if small doses of the glucocorticoids are administered.
b. Hypokalemic Alkalosis and Edema. As you will recall, mineralocorticoids
increase the absorption of sodium into the blood (thus less sodium leaves the body in
the urine) and decrease the reabsorption of potassium into the blood (thus more
potassium leaves the body in the urine). Thus, the patient who continues to ingest his
normal amount of sodium per day may find himself with edema (where sodium goes, it
takes water) and hypokalemia (more sodium stays in and makes more potassium leave
the body) if he is taking glucocorticoids.
c. Iatrogenic Cushing's Syndrome. As you will recall, Cushing's disease
results from hypersecretion of the adrenal glands. With iatrogenic Cushing's syndrome,
the excessive amounts of glucocorticoids present in the body can be attributed to the
medications the patient is taking. As you might expect, the same signs will be seen in
both types of patients, moon face, buffalo hump, edema, hypertension, etc.
d. Diabetes Mellitus. Persons taking glucocorticoids may find that their
diabetes is aggravated because of the glucocorticoid therapy. Also, the glucocorticoids
may make patients with latent diabetes into diabetics.
e. Moon Face and Buffalo Hump. These conditions, which are also found in
persons who suffer from hypersecretion of the adrenal glands, are also found in some
people who are administered glucocorticoids. See paragraph 9-6b for a review of this
f. Osteoporosis. This adverse effect is associated with the long-term
administration of large doses of these agents. Essentially, the gluco-corticoids
suppress the formation of bone and inhibit the absorption of calcium from the
g. Adrenal Insufficiency. When therapeutic amounts of glucocorticoids are
given for long periods of time, adrenocortical suppression occurs because therapeutic
levels of glucocorticoids tend to suppress the release of adrenocorticotropin (ACTH)
from the pituitary gland through negative feedback. See paragraph 9-9 for further
h. Increased Susceptibility to Infection. Persons taking glucocorticoids find
themselves to be susceptible to infection, especially tuberculosis, bacterial infections of
the skin, and fungal or yeast infections. Of real concern is the fact that glucocorticoids
tend to mask infections. Thus, infections can become severe before they are
i. Central Nervous System Effects. Persons taking large doses of
glucocorticoids can undergo personality and behavioral changes that are usually