#129 Steroids: 5 Pearls Segment

Core IM | Internal Medicine Podcast

Core IM Team

Mental Health, Education, Health & Fitness, Medicine

4.8 • 1K Ratings

🗓️ 28 June 2023

⏱️ 42 minutes

🔗️ Recording | iTunes | RSS

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Summary

How do you choose between the different steroids? At what dose and duration do you get concerned about worrisome complications? What types of prophylaxis should be started in patients on steroids and when?In which patients should we wean steroids vs. stop abruptly, and how should we do so? What factors limit steroid weaning?

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Show notes & Transcript

Time Stamps

02:59 Types of Corticosteroids
14:31 Side Effects of Steroids
21:15: Prophylaxis
27:32 Steroid Weaning
33:38 Steroid Weaning Limitations

Tags: IMCore, CoreIM, endocrine, adrenal insufficiency, internal medicine podcast, hospitalist, hydrocortisone, fludrocortisone, methylprednisolone, prednisone, dexamethasone, steroid withdrawal syndrome

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Transcript

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0:00.0	This episode will count for CME Credit with the American College of Physicians.
0:03.6	Click on the link in the show notes.
0:05.2	Follow the URL, answer three questions, and get CME Credit.
0:08.0	And with that, let's get on to the episode.
0:11.1	Do you know any other drug? Any other drug on the market? I mean if you tried to put steroids on the market right now if you try to get steroids past the FDA, there's no way right? There's way too many side effects to have steroids be FDA approved for anything and yet they're
0:24.5	FDA approved for like every autoimmune condition they're FDA approved for
0:28.0	COPD. You know there's so many different things that they're FDA approved for
0:30.6	just because they're grandfathered in.
0:33.0	That's Dr. Beth Wallace, a rheumatologist
0:34.8	at the University of Michigan.
0:36.1	And today we are talking all things
0:37.9	corticosteroids, aka steroids.
0:40.6	Gruco-cordicoids are a double-edged sword, or I don't know if you could make it a triple-edge.
0:44.2	There's a lot of benefits but also really salient, chronic, and acute issues with steroids.
0:50.0	And that was Dr. Michael Weintraub and endocrinologist at NYU.
0:53.7	I'm Dr. Shreh Trevetti and welcome to the Core I Am ThiPherls podcast bringing you
0:58.0	high-yield evidence-based pearls. And this episode is on steroids.
1:02.4	Really wouldn't have been possible without Dr. Casey Kim.
1:05.7	You flatter me, Shraya. But hi all, I'm Casey. I'm a second year internal medicine
1:11.6	resident at Beth Israel Deaconess Medical Center.
1:14.4	I was really excited to take into this topic because I felt like I was just using
1:17.8	steroids every day but not really understanding them.
	...

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