What precautions should be taken when using glucocorticoids and cytotoxic drugs?

Precautions when using glucocorticoids:
1. Monitor for adverse reactions: Adverse effects of glucocorticoids are closely associated with the specific agent used, dosage, duration of treatment, formulation, and route of administration. During therapy, close monitoring for adverse effects is essential—including infections, metabolic disturbances (e.g., fluid/electrolyte imbalances, hyperglycemia, dyslipidemia), weight gain, bleeding tendency, abnormal blood pressure, osteoporosis, avascular necrosis of the femoral head, etc. In pediatric patients, growth and development should also be carefully monitored.
2. Be vigilant for withdrawal reactions and rebound phenomena: When glucocorticoids are administered long-term or at high doses, rapid tapering or abrupt discontinuation may precipitate withdrawal reactions—manifesting as symptoms resembling adrenal insufficiency, such as lethargy, fatigue, anorexia, arthralgia, and myalgia; severe cases may present with fever, nausea, vomiting, and hypotension. Rebound phenomena may also occur, characterized by disease relapse or exacerbation. In such instances, glucocorticoid therapy must be reinstated—often at a higher dose—until disease stability is achieved, followed by gradual, cautious dose reduction.

Cytotoxic drugs are a class of agents that effectively kill immune cells and suppress their proliferation. These drugs can cause toxicity to multiple organ systems—including the reproductive, urinary, hepatic, and renal systems—via routes such as dermal absorption or inhalation, and they also carry teratogenic risks. Therefore, standardized procedures and appropriate occupational safety measures must be strictly adhered to during the preparation of cytotoxic drugs to minimize their harmful effects on human health.