Steroid treatment (indications, dose of equivalence, mechanism of action, side effects, prevention)

1. Big picture

Glucocorticoids are among the most important drugs in internal medicine because they are fast, powerful anti-inflammatory and immunosuppressive agents. They can be life-saving in autoimmune flares, allergic emergencies, vasculitis, asthma/COPD exacerbations, adrenal crisis, cerebral edema, and transplant rejection.

The exam expects you to know four things very well:

1. When to use steroids
2. How to choose and convert doses
3. How they work
4. How to prevent side effects

The central clinical rule is:

Steroids are excellent for rapid control,
but long-term uncontrolled use causes harm.
Use the lowest effective dose for the shortest possible t