● Antidiabetic agents or insulin (used to treat diabetes) can increase glucose (blood sugar) levels when taken with corticosteroids. ● Medicines containing potassium (used to treat high blood pressure) can interfere with potassium levels in the blood. ● Medicines containing sodium can cause the body to retain excess sodium and water, which can cause high blood sodium, high blood pressure, and excess body water. ● Licorice (candy made from the licorice plant’s root) can increase the effects of corticosteroid medications. ● Antacids (counteracts stomach acidity) can decrease the effectiveness of some corticosteroids. ● Anticonvulsants (used to treat seizures) can decrease the effectiveness of some corticosteroids. ● Phenylbutazone (used to treat fever and pain) can reduce the effectiveness of corticosteroids. ● Aminoglutethimide (used to treat some kinds of tumors) can reduce the effectiveness of corticosteroids. ● Griseofulvin (used to treat skin infections) can reduce the effectiveness of corticosteroids. ● Ephedrine may decrease the effectiveness of nasal corticosteroids. ● Ritodrine (used to stop premature labor) can cause serious side effects when taken with corticosteroids. ● Rifampin (antibacterial drug used to treat tuberculosis) may decrease the effectiveness of nasal corticosteroids. ● Barbiturates (group of drugs used as sedatives) can decrease the effectiveness of some corticosteroids. ● Mitotane (used to treat cancers that affect the adrenal cortex) can decrease the effectiveness of some corticosteroids. ● Amphotericin B by injection (used to treat fungal infections) can decrease the amount of potassium in the blood. pain medications used to treat severe pain. Examples of these medications are hydrocodone and oxytocin. Opioids can be highly addictive. These are very strong medications, and patients who are taking them should be advised about timing the medications around their session, taking them after their treatment so that they are able to provide more accurate pressure feedback. warning mechanism. Tissues that have reduced or altered sensitivity can be injured more easily by normal use of manual techniques. Dizziness, drowsiness, and postural hypotension are common side effects of many pain medications and symptoms can be heightened by massage. The client should sit up slowly and wait a few moments before standing. Because so many medications are associated with side effects including slight dizziness or drowsiness, be sure to assist individuals, especially the elderly, in sitting up, pausing a moment, and getting off the table. In many cases, the health and function of the liver and kidneys are critical to maintaining therapeutic levels of medication in the blood. If normal elimination processes are compromised by renal or hepatic dysfunction, adverse effects such as fever and reddish-purple bruises on the skin are early indications of drug toxicity. At any indication of drug toxicity related to any drug, manual therapy treatments are contraindicated until the individual is evaluated by a physician.
● Enemas/foams/suppositories ○ Burning or itching of skin.
○ Diarrhea. ○ Infection. ○ Rectal bleeding. ○ Sensation of pins and needles.
● Pastes
○ Infection. ○ Irritation, such as burning, itching, blistering, or peeling. Some side effects of corticosteroid drugs are considered more dangerous, though rare. An individual should immediately contact a physician if they experience any of these side effects: ● Blindness. ● Unusual confusion or excitement. ● Hallucinations. ● Mental depression. ● Eye pain. ● Irregular heartbeat. ● Bloody stool. ● Unusual increase in hair growth. ● Vomiting. Interactions with corticosteroids Patients who seek your advice should instead be urged to consult their physician before taking any additional prescriptions, over-the-counter medications, nutritional supplements, herbal medications, or certain foods. Of particular concern to individuals taking corticosteroids: ● Diuretics (water pills) can cause the diuretic to be less effective and may increase the loss of potassium. ● Heart medications can increase the risk of having an irregular heartbeat or other problems by decreasing the amount of potassium in the blood. ● Cyclosporine (used for autoimmune disorders, in addition to preventing transplanted organ rejection) can cause seizures when taken with some corticosteroids. inflammation and pain. There are over-the-counter pain medications such as paracetamol and NSAIDS, commonly called ibuprofen, acetaminophen , and aspirin . These drugs are taken frequently and are widely available to the general population to treat headaches, reduce fever, and soothe common aches and pains. There are also opioid prescription Therapeutic massage considerations Working with individuals taking pain medication requires extra attention to the patient's comfort and positioning. In cases where symptoms are elements of a systemic disorder, a shortened session may be appropriate. Deep tissue techniques for individuals who are taking pain medications is generally contraindicated because it prevents the patient from being able to give accurate feedback about pressure. Swollen tissues should be elevated to encourage drainage. Use supports and pillows to cradle body parts comfortably and safely. In cases where pain and inflammation are Pain medications The goal of taking pain medication is to reduce symptoms of a systemic disorder, a shortened session may be appropriate. Individuals in severe pain may not be able to tolerate any additional stress on their tissues. It is important that you are aware of all medications your patient is taking, both prescription and over the counter, as multiple medications increase the potential incidence of adverse effects. Optimally timing the medication around the therapy session may be critical to ensure that symptoms are managed effectively, or that individuals are not “masking” pain or discomfort that serves as the body’s feedback or
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