Adrenal and Antiadrenal Drugs

Question 1

Adrenal Drugs - general info

Answer 1

MOA:
Related to their involvement in synthesis of specific proteins

Indications:
Broad indications (pg. 536) - SEE PHOTO ON PHONE

Contraindications:
Drug allergy, cataracts, glaucoma, peptic ulcer disease (because drug can cause perforation in stomach), mental health problems, and diabetes; ALSO use caution with liver and renal failure

Adverse Effects:
Moon facies, hyperglycemia, psychosis, ALL adrenal drugs cause GI ADVERSE EFFECTS

Interactions:
Thiazides and loop diuretics (these lead to hypocalcemia and hypokalemia), aspirin and NSAIDS (increase peptic ulcer potential), antidiabetic drugs

Nursing Considerations:

Question 2

Fludrocortisone

Answer 2

Commonly prescribed mineralocorticoid drug

Addison’s disease & salt-losing adrenogenital syndrome

Interactions: hypokalemia with antifungals; thiazides and loop diuretics cause hypokalemia; can increase hyperglycemia

AE - water retention, muscle pain and weakness,

In general, Mineralocorticoid drugs work like aldosterone to increase H2O and NA+ retention and K+ excretion

Question 3

Prednisone

Answer 3

ORAL glucocorticoid and IMMEDIATE acting

Antiinflammatory or immunosuppressant purposes, asthma, chronic bronchitis

Immediate acting drug

Can increase BG levels and cause fluid retention

Question 4

Methylprednisolone

Answer 4

INJECTABLE glucocorticoid

Antiinflammatory or immunosuppressant drug

Very easily increases BG levels!

Question 5

Antiadrenal drugs

Answer 5

Aminoglutethimide:

• Adrenal steroid inhibitor
• Obstructs normal actions of adrenal cortex by inhibiting the conversion of cholesterol into adrenal corticosteroids
• Treatment of Cushing’s syndrome

AE’s: nausea, anorexia, dizziness, and skin rash are most common

Question 6

Patient Teachings

Answer 6

• Take glucocorticoids exactly as ordered & never abruptly discontinue
• Emphasize importance of BONE HEALTH with glucocorticoid therapy
• Call physician immediately with s/s of ADRENAL INSUFFICIENCY (decreased serum sodium and glucose levels, increased potassium levels, dehydration, and weight loss)
• Document daily weights - more than 2lb in 24 hrs or 5lb in 1 week, call doctor!!
• Medical alert bracelet