Corticosteroid Overdose - Causes, Symptoms, Diagnosis, and Treatment

Introduction

A particular type of steroid hormone produced by the body's adrenal gland is called corticosteroids. They play a crucial role in regulating a wide range of physiological functions, including the immune system, metabolism, and stress response. Corticosteroids are classified into two main types which include glucocorticoids and mineralocorticoids. Corticosteroids can be administered in several forms, including oral tablets, injectable solutions, and topical creams. The mode of administration depends on the medical condition being managed and the intensity of the symptoms.

What Are the Uses of Corticosteroids?

The uses of corticosteroids include:

• Autoimmune Diseases: Corticosteroids are commonly used to treat autoimmune diseases, such as lupus, multiple sclerosis, and others. They work by suppressing the immune system's activity, which can reduce inflammation and prevent damage to the affected tissues and organs.

• Allergic Reactions: Corticosteroids are also used to treat allergic reactions such as asthma, allergic dermatitis, and others. They function by lowering swelling and inflammation in the skin, airways, and other affected tissues.

• Inflammatory Bowel Disease (IBD): Corticosteroids are used to treat IBD (Crohn's disease and ulcerative colitis are two distinct forms of this condition ). They work by reducing inflammation in the gut and improving symptoms, such as abdominal pain, diarrhea, and rectal bleeding.

• Cancer Treatment: Corticosteroids are sometimes used to treat cancer, particularly in combination with other chemotherapy drugs. They can help to reduce inflammation, prevent nausea and vomiting, and improve appetite and energy levels.

• Skin Conditions: Multiple skin conditions, such as eczema, psoriasis, and hives, are treated with corticosteroids. It helps to minimize inflammation and itching. It can also make skin look better by enhancing its texture.

• Transplantation: Corticosteroids are used in organ transplantation to stop one’s immune system from attacking the transplanted organ. They are frequently taken in combination with other immunosuppressive medications to prevent rejection and improve the success of the transplantation.

What Are the Causes of Corticosteroid Overdose?

The common causes of corticosteroid overdose include:

1. Exceeding the Recommended Dosage of Medication: Overdose can occur when the patient takes more than the prescribed dose, takes the medication for a longer duration than recommended, or takes multiple medications that contain corticosteroids.

2. Self-Medication: Some individuals may self-medicate with corticosteroids to treat their medical conditions without consulting a doctor. This can lead to an overdose, as the individual may not be aware of the proper dose or duration of treatment.

3. Interactions With Other Medications: Corticosteroids can interact with medications like blood thinners, nonsteroidal anti-inflammatory drugs (NSAIDs), and some antibiotics, which can increase the risk of overdose.

4. Medical Conditions: Overdoses of corticosteroids may be more likely in certain medical conditions such as liver or kidney disease. The organs like the kidneys and liver are responsible for processing and eliminating the medication from the body. Individuals with these conditions may require a lower dose or a longer interval between doses to prevent overdose.

What Are the Symptoms of Corticosteroid Overdose?

The following are the symptoms of Corticosteroid overdose:

• Corticosteroid overdose can cause an increase in blood pressure, which can lead to hypertension if not properly managed.

• Rapid heart rate may be present as a result of an overdose. This can lead to heart palpitations and other cardiovascular complications.

• Fluid retention and swelling in the face, hands, feet, and legs. This can lead to discomfort, difficulty moving, and increased risk of infection.

• An increase in body weight, especially around the face, neck, and abdomen.

• Muscle weakness and fatigue can make it difficult to perform daily activities.

• Mood changes (anxiety, depression) may be present.

• Corticosteroids can interfere with sleep, leading to insomnia and other sleep disorders.

• A rise in blood sugar levels, results in diabetes or worsen existing diabetes.

• Corticosteroids can weaken the immune system, making the individual more susceptible to infections.

• An overdose of corticosteroids can cause Cushing's syndrome, which is characterized by a round face, fatty hump between the shoulders, and thinning of the arms and legs.

• In severe cases, corticosteroid overdose can lead to life-threatening complications, such as heart failure, respiratory failure, or coma.

How to Diagnose Corticosteroid Overdose?

The healthcare professional will take a detailed patient's medical history, including any medications taken and the duration and dosage of corticosteroids. They will usually conduct a physical examination to assess for any symptoms or side effects of corticosteroid overdose. The diagnostic tests done to detect overdose include:

1. Blood Tests: Blood tests are one option for detecting the level of corticosteroids in the blood and assessing for any changes in electrolyte levels or blood glucose levels. This can help confirm the diagnosis of corticosteroid overdose and guide treatment.

2. Urine Tests: Urine tests can measure the level of corticosteroids in the urine and assess for any changes in electrolyte levels or urinary tract infections.

3. Imaging Tests: X-rays or computed tomography (CT) scans may be advised to identify any changes in bone density or the development of adrenal gland problems.

4. Electrocardiogram (ECG): An ECG may be performed to assess for any changes in heart rate or rhythm.

5. Other Tests: Additional tests such as liver function tests, or kidney function tests may be ordered based on the individual's symptoms and medical history.

What Is the Treatment for Corticosteroid Overdose?

The treatment options for corticosteroid overdose include the following:

• Reduce or Stop Corticosteroid Use: The first step in treating corticosteroid overdose is to reduce or stop the use of corticosteroids. This can help prevent further complications and give the body time to recover from the side effects of the medication.

• Supportive Care: Supportive care involves managing the symptoms of corticosteroid overdose. This may include managing high blood pressure, treating infections, and addressing mood changes.

• Fluid Management: Fluid management involves regulating the balance of fluids in the body to prevent fluid retention and swelling. This may involve diuretics or intravenous fluids.

• Blood Sugar Management: Blood sugar management involves regulating blood sugar levels to prevent or treat diabetes. This may involve insulin therapy or dietary changes.

• Adrenal Function Testing: This testing may be performed to assess for any damage to the adrenal glands, which can occur with long-term corticosteroid use. If adrenal gland function is compromised, hormone replacement therapy may be necessary.

• Psychological Support: Psychological support may be necessary to address any mood changes or psychiatric symptoms that may arise as a result of corticosteroid overdose.

Conclusion

Corticosteroid overdose is not common, but it can occur with excessive or prolonged use of corticosteroid medications. Corticosteroid medications should be used for the prescribed duration of treatment. Regular monitoring of corticosteroid use can help prevent overdose to a certain extent. It is crucial to inform doctors of any other medications, supplements, or herbs being taken to avoid potential interactions with corticosteroids. Mild to moderate overdose may be managed with supportive care, while severe overdose may lead to serious complications.