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Corticosteroid sick day and adrenal suppression — GPhC CRA MCQ

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HardEndocrine TherapeuticsCorticosteroid sick day and adrenal suppressionGPhC CRA

A 62-year-old woman takes prednisolone 10mg daily for polymyalgia rheumatica and has done so for 4 months. She has influenza-like illness with fever and poor oral intake. She asks whether she should stop prednisolone until she recovers. What would you advise the patient?

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Correct answer: B — Continue prednisolone and seek urgent advice if unable to keep doses down

Longer-term systemic corticosteroid use can suppress the adrenal axis, so abrupt cessation is unsafe. During intercurrent illness, patients should continue prescribed steroids and seek urgent medical advice if vomiting or unable to take doses. Infection risk should be managed clinically, not by sudden steroid withdrawal. NSAID substitution is not equivalent and may add gastrointestinal and renal risk.

Reference: BNF Corticosteroids; NICE CKS Corticosteroids - oral