The term Cushing syndrome refers as the manifestations of excessive corticosteroids, most commonly due to supra physiologic doses of corticosteroids drugs and rarely due to spontaneous production of excessive corticosteroids by the adrenal cortex. In this case a 22 year old male patient came to the tertiary care hospital with the complaint of skin lesions over the body over three months. Patient taking injection of dexamethasone from the last 8 months, taking 2 doses within 15 days. On examination multiple erythematous, dry scaly plaques seen, multiple striae seen over bilateral crural folds, facial puffiness since eight months, abdominal distension. The patient was diagnosed with iatrogenic cushing's syndrome with tinea cruris with tinea corporis with acne eruption and also newly detected hypertension. Early detection of adverse effects can reduce the risk of occurrence of any other disease.
Tramadol is most commonly used opioid analgesic. It has a very rare and serious endocrine metabolic side effect as hypoglycaemia. The reason behind hypoglycaemia is still unclear but it may lead due to increased insulin concentration and utilization of glucose by muscles. In this report, a patient is prescribed tramadol for toothache. This report focuses on hypoglycaemia due to tramadol administration. Clinical Pharmacists should be at bedside to alert regarding any Adverse Drug Reaction. Regular monitoring of patients can decrease the mortality rate which is occurring due to ADR.
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