High-Dose IV Steroids and Temperature Regulation Side Effects

Metabolic Side Effects

Hyperglycemia is the most common metabolic side effect of high-dose IV methylprednisolone, particularly in the first 36 hours following an initial bolus, according to the American College of Clinical Pharmacology 1
Sleep disturbances are frequently reported with high-dose steroid therapy, as noted by the American Academy of Sleep Medicine 1

Increased infection risk occurs due to immunosuppressive effects of high-dose IV steroids, as reported by the Infectious Diseases Society of America 2, 1
Atrial fibrillation risk increases dramatically with high-dose corticosteroids (≥7.5 mg prednisone equivalents), with an odds ratio of 6.07, according to the American Heart Association 3

When patients report "hot flashes" or sweating during high-dose IV steroid therapy, consider assessing for hyperglycemia, which can cause diaphoresis, as recommended by the American Diabetes Association 1
Evaluate for infusion-related reactions if symptoms occur during or immediately after administration, and consider cardiac monitoring for patients receiving high-dose IV pulse therapy (≥500 mg methylprednisolone or equivalent), as suggested by the American College of Cardiology 3