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Steroid withdrawal — GPhC CRA MCQ

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HardEndocrine TherapeuticsSteroid withdrawalGPhC CRA

A 68-year-old man on long-term prednisolone 10mg daily for polymyalgia rheumatica collects a new prescription. He says he stopped taking it yesterday because he felt well and now feels weak and dizzy. BP is 92/58mmHg. What would you advise the patient?

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Correct answer: C — Seek same-day urgent medical advice because adrenal insufficiency is possible

Long-term systemic corticosteroids suppress the hypothalamic-pituitary-adrenal axis, and abrupt discontinuation can cause adrenal insufficiency. Weakness, dizziness and low blood pressure after stopping prednisolone are concerning and require urgent clinical advice. Restarting or adjusting steroids should be medically directed. NSAIDs do not treat adrenal insufficiency.

Reference: BNF; NICE CKS Corticosteroids