AdrenoCortical Medications Flashcards
Glucocorticoid
Medications:
Hydrocortisone, Dexamethasone, Methylprednisolone, Prednisone, Beclomethasone, Betamethasone, Budesonide
Glucorticoid
Adverse Effects:
Increases susceptibility to infx. May mask symptoms of infx. Edema, changes in appetite. Euphoria, insomnia. delayed wound healing. Hypokalemia, hypocalcemia. Hyperglycemia. Osteoporosis, fractures. Peptic ulcer, gastric hemorrhage. Psychosis.
Glucocorticoid
Nursing Considerations
Prevents/suppresses cell-mediated immune reactors
Used for adrenal insufficiency. Overdosage= Cushing’s syndrome. Abrupt withdrawal of drug may cause headache, nausea, and vomiting, and papilledema ( Addisonian crisis). Give single dose before 0900. Give multiple doses at evenly spaced intervals. Infx may produce few symptoms d/t anti inflammatory action
Glucocorticoid
Nursing Considerations ( cont’d)
Stress( sx, illness, psychic) may lead to increased need for steroids. Nightmares are often the 1st indication of the onset of psychosis. Check weight, BP, electrolytes, I&Os. Used cautiously w/history of TB ( may reactivate disease).
Glucocorticoid
Nursing Considerations ( cont’d)
May decrease effects of oral hypoglycemics, insulin, diuretics, K+ supplements. Assess children for growth restriction. Protect from pathological fractures. Administer w/antacids. Do NOT stop abruptly. Methylprednisolone also used for arthritis, asthma, allergic, rxns, cerebral edema. Dexamethasone also used for allergic disorders, cerebral edema, asthma attack, shock.
Glucocorticoid
Action
Stimulates formation of glucose ( gluconeogenesis) and decreases use of glucose by body cells; increases formation and storage of fat in muscle tissue; alters normal immune response
Glucocorticoid
Indications
Addison’s disease. chron’s disease, COPD, lupus erythematosus, leaukemias, lymphomas, myelomas, head trauma, tumors to prevent/treat cerebral edema.
Glucocorticoid
Adverse effects
Psychoses, depression, weight gain, hypokalemia, hypocalcemia, stunted growth in children, petechiae, buffalo hump
Glucocorticoid
Nursing Considerations
Monitor fluid and electrolyte balance
Don’t discontinue abruptly
Monitor for signs of infection
Glucocorticoid
Herbal Interactions
Cascara, senna, celery seed, juniper may decrease serum potassium; when taken with corticosteroids may increase hypoglycemia. Ginseng taken with corticosteroids may cause insomnia. Echinacea may counteract effects of corticosteroids. Licorice potentiates effect of corticosteroids.
Mineralocorticoid
Fludrocortisone acetate
Adverse effects: Hypertension, edema d/t sodium retention. Muscle weakness and dysrhythmia d/t hypokalemia.
Mineralocorticoid
Fludrocortisone acetate
Nursing Considerations: Give PO dose w/food. Check BP, electrolytes I&O, weight. Give low sodium, low protein, high potassium diet. May decrease effects of oral hypoglycemics, insulin, diuretics, K+ supplements
Mineralocorticoid
Fludrocortisone acetate
Action: Increases sodium re-absorption, potassium and hydrogen excretion in the distal convoluted tubules of the nephron.
Indications: Adrenal insufficiency
Mineralocorticoid
Fludrocortisone acetate
Adverse Effects: Sodium and water retention, Hypokalemia
N.C: Monitor BP and serum electrolytes. Daily weight, report sudden weight gain to HCP. Used with cortisone or hydrocortisone in adrenal insufficiency.
