Corticosteroid Therapy and Tapering is a medication safety topic with immediate life-threatening consequences when managed incorrectly. Long-term supraphysiologic steroid use suppresses the HPA axis — the hypothalamus and pituitary stop signaling, the adrenal glands atrophy, and they can no longer produce cortisol independently. Abrupt discontinuation of corticosteroids after >2–3 weeks of continuous use causes acute adrenal insufficiency (crisis). Tapering principle: reduce the dose gradually over weeks to months, giving the HPA axis time to recover. The duration of suppression correlates with dose and duration of therapy. Stress dosing: during moderate illness (fever, minor surgery, significant stressor), the patient needs 2–3× their usual dose because the adrenal cannot mount a normal stress cortisol response. The nurse teaches: never stop steroids abruptly, carry Medic-Alert identification, know crisis signs (nausea, vomiting, abdominal pain, hypotension, confusion), and use emergency injection kit. Side effects requiring nursing monitoring: hyperglycemia, immunosuppression (no live vaccines), osteoporosis, peptic ulcer risk, fluid retention, hypertension, cataracts, and mood changes.