By Paul Saunderson

ISBN-10: 0947543236

ISBN-13: 9780947543235

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Additional info for How to Recognise and Manage Leprosy Reactions (ILEP learning guides on leprosy)

Example text

Complications should be managed appropriately. If it is decided that the steroids should be stopped, this must be done gradually over a period of some weeks. If a person suddenly stops taking steroids while on a high dose, the following symptoms can occur: hypotension, weakness and shock. Restart steroids and give supportive treatment, including intra-venous fluids, if necessary. The person should be admitted to hospital as an emergency. qxd 1/5/03 9:29 am Page 51 There are other complications of steroids, but they are rarely a problem if the course lasts less than six months.

At each visit you should ask the person about any side effects or other problems, carry out a nerve function assessment to monitor changes and give them prednisolone for the next stage of the treatment. Monitoring nerve function Monitor each person by using a routine care form (see Annex A), which provides a record of the changes in nerve function. If you discover definite deterioration, refer the patient for specialist advice – but continue with the same dose of prednisolone in the meantime. The specialist may prescribe an increased or prolonged course of steroids under close supervision.

The reason for treatment Explain that the person needs the drugs because of the new nerve damage, and that symptoms such as pain and loss of feeling and/or strength, if present, are likely to improve within one to two weeks. If the person has no pain, explain that untreated nerve damage could lead to disability and deformity. qxd 1/5/03 9:28 am Page 27 You should also mention that some symptoms might remain after treatment (for example, sensory loss or muscle weakness may only partially recover), but that treatment is essential to prevent the damage from becoming worse.

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How to Recognise and Manage Leprosy Reactions (ILEP learning guides on leprosy) by Paul Saunderson


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