Which of the following is NOT an adverse effect of systemic corticosteroids?

The correct choice identifies that paradoxical bronchospasm is not an adverse effect of systemic corticosteroids. While systemic corticosteroids are used to manage asthma and help reduce inflammation, paradoxical bronchospasm refers to a situation where the use of certain bronchodilators causes tightness in the chest or increased wheezing rather than relief. This is more commonly associated with rapid-acting bronchodilators rather than corticosteroids, which primarily function by decreasing inflammation.

The other options represent well-documented adverse effects associated with systemic corticosteroid use. Hypertension can occur due to the fluid retention and electrolyte imbalances that corticosteroids can cause. Bone density loss is a recognized long-term effect of corticosteroid therapy, particularly with prolonged use, as it can inhibit bone formation and lead to osteoporosis. Immunosuppression is another significant concern, wherein corticosteroids can suppress the body's immune response, increasing susceptibility to infections.

Understanding the specific side effects of medications, especially in the context of asthma management with corticosteroids, is crucial for recognizing both the benefits and risks involved in their use.