Weight gain: Restrict calorie intake; may require a change in steroid medication: may require a diuretic.
Edema: May require diuretics and potassium.
Potassium loss: Use potassium supplement.
Acne: Treat with topical medications.
Urinary frequency and nocturia: Check for evidence of genitourinary infection or diabetes mellitus; urinalysis
Insomnia, headache, fatigue, euphoria. Treat symptomatically.
Side Effects of Steroid Therapy - considered undesirable and dangerous by the prescriber,
Nature of Effect Action
Allergic reaction to ACTH or steroid: Withdraw drug promptly. Substitute steroid or synthetic ACTH.
Cardiovascular system effects
- Hypertension: Suggest reduction in dosage of steroids.
Thromboembolic complications
Infection: Suggest anti-microbial medications as indicated.
Eye complications:
- Glaucoma - refer to ophthalmologist.
- Corneal lesions
- Subcapsular cataract
Musculoskeletal effects:
- Osteoporosis
- Pathologic fractures
- Growth suppression
- Myopathies
Central nervous system
- Seizures: refer to neurologist.
- Neuritis
- Psychotic reactions
- Adrenal insufficiency (after steroid withdrawal)
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Whilst working in conservation and lecturing in ecology and the eco-crisis for the University of Wales, David Hoffman became convinced that to heal the world, to embrace planetary wholeness and responsibility for it 
