effects similar to corticosteroids, nsaids should be used for short periods of time due to the risk of side effects. common side effects of nsaids include stomach ulcers headaches, drowsiness allergic reactions. rarer side effects consist of complications affecting the liver, kidneys or heart and circulation, potentiating the cause of heart failure, heart attacks and strokes. corticosteroids corticosteroid is a class of drugs that features the reduction of inflammation and suppression of the immune system. common medication includes prednisone and cortisone. these corticosteroids can be taken orally or can be injected directly into the painful joints. due to the extensive risk of side effects associated with the use of corticosteroids, it is generally recommended for short term therapy. for example, during a flare-up or an episode of arthritic symptoms, short-term corticosteroids are administered to rapidly decrease inflammation of the joints. mechanism of action corticosteroids mediates multiple steps in the inflammatory pathway. to exert an effect, the steroid compound binds toglucocorticoid receptors. as a result, the receptors changes their conformation and influences glucocorticoid response elements. these elements are connected with either suppression or stimulating transcription of genes responsible for ribonucleic acid and protein synthesis. corticosteroids are responsible for inhibiting transcription factors that control the synthesis of proinflammatory molecules, including macrophages, eosinophils, lymphocytes, mast cells, and dendritic cells. corticosteroids also exert their effect by inhibiting phospholipase a2. phospholipase a2 controls the production of various inflammatory mediators. side effects injected corticosteroids may cause : gastrointestinal irritation discomfort tachycardia nausea insomnia metallic taste in the mouth. patients taking short term oral corticosteroids may experience : mood alterations (feeling anxious or irritated) insomnia fluid retention an increase in appetite. long term usage may lead to more severe complications including : osteoporosis hypertension diabetes muscle weakness increased vulnerability to infection glaucoma. in case of facing severe side effects, the drug should not be stopped suddenly. if corticosteroids are stopped abruptly, the patient may experience fatigue, nausea, vomiting, diarrhoea, and abdominal pain.