Question

Case Study #11 on long-term Steroid Use Name R.T. is a 62 year old male with a history of severe asthma starting when he was 7 years old. Over the years, he has repeatedly been treated with aminophylline and courses of oral steroids for acute exacerbations of asthma. Frequent courses of steroids as a child, he stated, caused his growth to be stunted and he is only 61" tall. Although steroids can decrease the airway inflammation produced by asthma, R.T. developed other side effects that made him wonder if it was worth the benefit. During his early 30s, he was on high-dose prednisone for 3 months and developed diabetes. He is currently on inhaled steroids and a long-acting beta-2 agonist. He also has HTN for which he takes a diuretic and an ACE inhibitor. He's also had several fractures attributed to his history of extensive steroid use. He is being evaluated today for bloody stools and weight loss, and is scheduled for a colonoscopy. 1. Why are steroids effective for the treatment of asthma? 2. Is it really possible that frequent steroid doses stunted his growth? 3. How does a steroid affect the blood sugar level? 4. Could frequent doses of steroid have contributed to R. T. being more likely to fracture a bone with an injury? 5. Could long-term use of steroids made colon cancer more likely?

Answer 1

1. Steroids are effective for the treatment of asthma because this drug works by minimising the inflammation, swelling and mucus production in the airway or during the respiration in the person suffering from asthma. Because of this, the airway is less inflamed and becomes less likely to react to asthma triggers. This helps to allow the people with the symptoms of asthma to have a better control over their condition.

2. Yes it is possible that frequent steroid use did stunted his growth because the steroids increases the muscles but has a side effect where if taken on regular basis stunts the growth especially in the teenagers as the steroids helps in maturing of the bones very fast and this leads to the storage of the body growth too early.

3. The steroids effects the blood sugar level by causing steroid induced diabetes if taken on regular basis. They are most susceptible of getting type 2 diabetes mellitus.

4. Yes frequent use of the steroids has contributed to R.T being more likely to fracture a bone with an injury because the long use of steroids causes major effects in the metabolism of calcium, vitamin D and bone. This can ultimately lead to broken bones, osteoporosis and broken bones.

5. Long term use of steroids can cause ulcer in the stomach but in very rare case along with other influential factors may cause colon cancer. Steroids are also used for the treatment of the cancer .