Question

Mrs. A has been taking high doses of glucocorticoids for much of the past 2 years to control severe rheumatoid arthritis. She has now developed hypertension and type 2 diabetes and would like to stop taking the cortisone because of the unwanted changes in her appearance.

Discussion Questions

How does Cushing’s syndrome affect the individual?

Discuss how hypertension and diabetes have developed and the potential complications of these conditions.

Discuss other potential problems that Mrs. A may experience resulting from long-term use of glucocorticoids

Answer 1

CUSHING SYNDROME: is a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol and sometimes called as hypercortisolism.

USE OF GLUCOCORTICOIDS: These medicines are highly effective in stopping damaging inflammation caused by many immune system disorders and also helps to reduce stress and

HOW DOES CUSHING SYNDROME AFFECT THE INDIVIDUAL? Cushing syndrome affect the individual due to administration of excessive amount of glucocorticoids.

DISCUSS HOW HYPERTENSION AND DIABETES HAVE DEVELOPED AND THE POTENTIAL COMPLICATIONS OF THESE CONDITIONS? A. Medications known as glucocorticoids are mainly used as anti-inflammatories or as anti-rejection drugs. One of the side effects of this drug is to increase blood glucose producion in the liver and reduce the sensitivity of the cells to insulin. Consequently, glucose accumulates in the blood and results in a rise in blood sugar level causing diabetes. B. The use of excess amount of glucocorticoids can cause high blood pressure in both normotensive and hypertensive patients. The reason is that glucocorticoids cause the body to retain fluids. This extra fluid in the circulation can cause an increase in blood pressure. So it is necessary to monitor the blood pressure daily those who are taking glucocorticoids. OTHER POTENTIAL COMPLICATION INCLUDES a) absorption of calcium which leads to osteoporosis b) increase cholesterol and triglyceride levels c) cause ulcers and gastritis d) suppress immune system and results in infections.

LONG TERM USE OF GLUCOCORTICOIDS can cause a loss of muscle tissue in Mrs. A which further results in a) cushing syndrome b) weight gain c) weakened bones d) diabetes e) blood pressure f) slow healing g) acne h) irregular menstrual cycle i) fatigue and j) depression.