Adrenal Drugs

Question 1

Prednisone

Chemical Classification

Answer 1

Intermediate-acting glucocorticoid

Question 2

Prednisone

Mechanism of Action

Answer 2

Decreases inflammation by increasing capillary permeability and lysosomal stabilization, minimal mineralcorticoid activity

Question 3

Prednisone

Uses

Answer 3

Severe inflammation, immunosuppression, neoplasms, multiple sclerosis, collagen disorders, dermatologic disorders

Question 4

Prednisone

Contraindications

Answer 4

Child <2yr, psychosis, hypersensitivity, idiopathic thrombocytopenia, acute glomerulonephritis, amebiasis, fungal infections, nonasthmatic bronchial disease, AIDS, TB, measles

Question 5

Prednisone

Side Effects

Answer 5

CNS: depression, flushing, sweating, headache, mood changes
CV: hypertension, CIRCULATORY COLLAPSE, THROMBOPHLEBITIS, EMBOLISM, tachycardia
EENT: fungal infections, increased intraocular pressure, blurred vision
GI: diarrhea, nausea, abdominal distention, GI HEMORRHAGE, increased appetite, pancreatitis
HEMA: THROMBOCYTOPENIA
INTEG: acne, poor wound healing, ecchymosis, petechiae
META: hyperglycemia
MS: fractures, osteoporosis, weakness

Question 6

Prednisone

Nursing Considerations

Answer 6

ASSESS:

• ADRENAL INSUFFICIENCY: nausea, vomiting, anorexia, confusion, hypotension, weight loss before, during treatment; HPA suppression may be precipitated by abrupt withdrawal
• Potassium, blood glucose, urine glucose while patient receiving long-term therapy, normal: 138-635 nmol/L SI units drawn at 8 AM
• Weight daily; notify prescriber of weekly gain of >5lb
• BP q4hr, pulse; notify prescriber of chest pain; monitor for crackles, dyspnea if edema is present; hypertension, cardiac symptoms
• I&O ratio; be alert for decreasing urinary output, increasing edema
• INFECTION: increased temp, WBC, even after withdrawal of medication; product masks infection
• Potassium depletion: paresthesias, fatigue, nausea, vomiting, depression, polyuria, dysrhythmias, weakness
• Mental status: affect, mood, behavior changes, aggression

PERFORM/PROVIDE:
-Assistance with ambulation for patient with bone-tissue disease to prevent fractures

Question 7

Prednisone

Functional Classification

Answer 7

Corticosteroid