Endocrine system: Adrenocortical agents Flashcards
Chapter 36 bookie
Describe the adrenal medulla?
Back up for sns
-releases noepinephrine and epinephrine into circulations when sns is stimulated
Describe the adrenal cortex?
-produces corticosteroids
-Adrogens
-Glucocorticoids : Increase blood glucose levels, fat deposits, and protein breakdown for energy
-Mineralocorticoids: Cause NA water retention (think aldersterone!)
***Hydrocortisone and prednisone have both glucocorticoid and mineralocorticoid activity
What are adrenocortical agents?
-Suppress the immune system not a cure
Short term use:
-Relieve inflammation,
-suppress immune system
-Replacement therapy when adrenals are not working
Long term use:
severe. depilating conditions
What are the indications of corticosteroids ?
-Allergies
-Connective tissue disorders caused by inflammation
-Skin disorders: contact dermatitis, rashes
-Endocrine disorders: hypothyroid
-GI disease with inflammatory cause (Crohn’s)
-Blood disorders with autoimmune causes: hemolytic anemia
-Cancer- lymphomas
-Neurologic conditions, brain edema, autoimmune disease (MS, MG)
-Eye disorders such as optic neuritis
-Organ transplantation
-Asthma, resp. disorders
-Rheumatic disorders
-Replacement therapy for adrenal insufficiency
What is a glucocorticoid medication?
**prednisone (Deltasone
What is the therapeutic actions of prednisone (Deltasone)?
Glucocorticoids
-Enter target cells and bind to cytoplasmic receptors, which causes effects of inflammatory and immunosuppressive effects
-Named for stimulation of glucose energy
What are adverse effects of prednisone (Deltasone)
Glucocorticoids
-Labile emotions/Mental status changes: Short or long term use can lead to steroid psychosis, anxiety,insomnia
-Delayed growth and development in children
-Increased rbc leading to vascular stasis, risk of DVT, if on bed rest
-Masking of signs and symptoms on infection
-Altered fat distribution
What is a adverse effect related to long term use of Glucocorticoids?
CUSHING SYNDROME !!!
-Moon face/ buffalo hump
-Thin extremities( Protein wasting)
-Skin changes
purple striae, thin skin
-Water retention
edema, hypertension
-K+ loss
-Osteoporosis
-Delayed wound healing
-Bruising
-Weight gain
-Diabetes Mellitus
What contras and cautions should you have when eating glucocorticoids
- Do not give when there is a infection going on because it supresses the immune system
-Be cautious with diabetes because it can increase blood glucose so monitor closely
-Monitor for stomach ulcers because they can be developed
-Becareful with endocrine disorders because increasing cortisols can mess with the function of other endocrine glands
-Pregnancy/lactation
**Glucocorticoid
What does adrenal suppression do?
-Causing body’s own production to stop producing their own cortisol
-Causes impaired stress response; pt unable to respond to stress ex; surgery, trauma
-Use short courses, taper and off whenever possible
What are glucocorticoid patient teaching?
-Do not stop abruptly
-Medical alert bracelet, so healthcare providers knows
-Avoid exposure to infection and noticing signs and symptoms of infection
-Vaccines, no live viruses
-Notify pcp for fever greater than 100
-Monitor blood sugars
-Weights-fluid retention you may see more weight gain and fluid retention
-Adjust dose if stressed(Long term usage)
-Diet- salt restriction
-Steroids can be used as inhalation tecahing
-Take oral preps with meals in the morning
Describe mineralcorticoids?
-Affect electrolyte, homeostasis, and fluid balance
-Increase sodium and water retention and potassium excretion
-Classic mineralocorticoid:aldosterone
What is fludrocortisone (Florinef)?
Mineral corticoids
What does fludrocortisone (Florinef) do used for?
Mineralocorticoids
Used for adrenal insufficiency in combination with glucocorticoids
off label –>hypotension
like adisons disease
What are adverse effects fludrocortisone (Florinef) ?
Mineralocorticoids
R/t increased fluid volume (Na/water retention)
-Possible hypokalemia
