Corticosteroids

Question 1

fluticasone

Flonase

Answer 1

Purpose: treatment of chronic asthma and of seasonal and perennial rhinitis

Side effects: hoarseness, oropharyngeal fungal infections, HA, nasal congestions, cold symptoms, N/V/D, epistaxis/nasal irritation, dyspnea

Nursing considerations:

• Nasal spray: onset within 2 days, peak 1-2 weeks
• Use regular peak flow monitoring to determine respiratory status

Question 2

fluticasone propionate salmeterol

Advair Diskus

Answer 2

Purpose: treatment of asthma that is not well controlled with long term corticosteroids, treatment of COPD

Side effects: agitation, oropharyngeal fungal infections, HA, blurred vision, n/v/d, increased cough, bronchitis

Nursing consideration:

• Nasal spray: onset few dyas, peak 3-4 days
• PO/IM: peak 1-2 hours
• Use regular peak flow monitoring to determine respiratory status

Question 3

mometasone

Nasonex Spray

Answer 3

Purpose: treatment of chronic asthma and of seasonal or perennial rhinitis

Side effects: Anemia (long-term use)
liver and kidney failure, dyspnea (prolonged high doses), angioedema, hives/itching

Nursing consideration:

• PO onset less than 1 hour, peak 30 min to 2 hours, duration 4-6 hours
• Rectal: onset slow, peak 1-2 hours, duration 3-4 hours
• Take curhsed or whole with full glass of water
• Can give with food or milk to decrease GI upset
• Signs of chronic poisoning: rapid, weak pulse, dyspnea, cold, clammy extremities
• signs of chronic overdose: bleeding, bruising, malaise, fever , sore throat, anorexia, jaundice