MEDizzy - A 65-year-old m an complained to his physician of epigastric

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Corticosteroids and Antagonists

A 65-year-old m an complained to his physician of epigastric distress, muscle weakness, hypertension, and white plaques in his mouth. The patient, diagnosed with polyarteritis nodosa 8 months ago, had been receiving an appropriate therapy since then. Laboratory values showed fasting blood glucose of 135 mg/dL (norm al 70−110 mg/dL) and blood urea nitrogen (BUN) of 40mg/dL (norm al 7−18 m g/dL). Which of the following drugs most likely caused the patient’s signs and symptoms?

Explanationc The patient’s signs and symptoms indicate he was suffering from adverse effects of chronic glucocorticoid therapy. Polyarteritis nodosa is a connective tissue disorder of unknown cause that is usually treated with high doses of glucocorticoids. Chronic treatment with these drugs can cause epigastric distress because of increased peptic acid secretions and inhibition of prostaglandin synthesis, muscle weakness because of muscle wasting, hypertension (mechanism still uncertain), and candidiasis (oral white plaques) because of the immunosuppressive effect that increases the probability of opportunistic infections. These drugs can also increased BUN because of protein wasting.