A patient on corticosteroid medication is at increased risk for which complication during dental procedures?

Correct answer: A. Adrenal insufficiency/adrenal crisis under stress

• A. Correct. Long-term corticosteroid use suppresses the hypothalamic-pituitary-adrenal (HPA) axis, causing adrenal insufficiency. Under the physiologic stress of dental procedures, the patient cannot mount a normal cortisol stress response, risking an adrenal crisis (hypotension, weakness, nausea, cardiovascular collapse). Steroid supplementation may be needed.
• B. Neuroleptic malignant syndrome is related to antipsychotic medications — not corticosteroids.
• C. Malignant hyperthermia is triggered by volatile anesthetic agents — not related to corticosteroids or dental procedures.
• D. Local anesthetics do not cause respiratory depression under corticosteroid use.