Side effects of glucocorticoid treatment: experience of the Optic Neuritis Treatment Trial
Glucocorticoid treatment for optic neuritis appears to be safe, but minor side effects are common. Optic neuritis is the inflammation of the optic nerve. Glucocorticoids have been in use for more than 40 years, but most studies on their side effects have examined those associated with their long term use. Of 457 patients with acute optic neuritis, 151 received IV methylprednisolone followed by oral prednisone, 156 received oral prednisone and 150 received placebo. Patients who took IV methylprednisolone and those who took oral prednisone reported sleep disturbances, mood changes, upset stomach and facial flushing more often than those who took placebo. One patient who took IV methylprednisolone developed severe depression and one developed acute inflammation of the pancreas. No serious side effects were reported by patients who took oral prednisone alone and those who took placebo.
Publication Name: JAMA, The Journal of the American Medical Association
Brief reports: treatment of vasospastic amaurosis fugax with calcium-channel blockers
Calcium-channel blockers may be an effective treatment for vasospastic amaurosis fugax. Vasospastic amaurosis fugax is a temporary loss of vision in one eye caused by a spasm of the blood vessels. Calcium-channel blockers were used to treat nine patients between 25 and 79 years old who had frequent attacks of vasospastic amaurosis fugax. Eight patients were treated with between 30 and 60 milligrams (mg) of nifedipine per day, and one was treated with 120 mg of verapamil per day. All the patients improved after treatment with an appropriate dose of a calcium-channel blocker. Four patients experienced a recurrence of symptoms after discontinuing treatment. Their symptoms disappeared after they resumed treatment. Anticoagulant or antiplatelet therapy is used to treat amaurosis fugax with other causes.
Publication Name: The New England Journal of Medicine
- Abstracts: A controlled trial of corticosteroid injections into facet joints for chronic low back pain. Epidural corticosteroid injections for sciatica due to herniated nucleus pulposus
- Abstracts: A controlled trial of a program for the active management of labor. The risk of cesarean delivery with neuraxial analgesia given early versus late in labor
- Abstracts: Play it clean: it's more fun without steroids. Building the "thigh biceps". Calf-machine traps? Leg-extension neck? Weight-belt calves?
- Abstracts: A 47-year-old man with recurrent fever and fulminant hepatic failure 31 days after a liver transplant. Peginterferon Alfa-2a plus ribavirin versus interferon Alfa-2a plus ribavirin for chronic hepatitis C in HIV-coinfected persons