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High Dose Steroid Pre-Treatment Checklist
Last updated 4th March 2024
Content by Dr Anne Drever
Checklist for use prior to commencing prednisolone 30mg per day or above, or other equivalent dose corticosteroid for more for > 4 weeks
A = Acid suppression
- Recommend for all patients with GCA starting high dose steroid
- Consider for other groups of patients on high dose steroid who are at high risk of GI bleeding or dyspepsia by virtue of their age, past history, or co-prescription of drugs known to increase upper GI side effects eg blood thinners, NSAIDs
B = Blood Glucose
- Check HBA1c in all prior to commencing steroid
- Consider BG daily at lunch or tea time for those not known to have diabetes
- 4x daily BG monitoring for those known to have diabetes
- For further details, see handbook page on Hyperglycaemia and Steroids
B = Bones
- Check vitamin D & calcium
- Consider supplements & bisphosphonate after correcting any vitamin D deficiency
C = Counsel re condition & steroid side effects
D = Dates provided for next steroid reduction & follow up
E = Ensure sufficient supply of steroid
Content by Dr Anne Drever