Mod 8- Adrenocortical Agents Flashcards

1
Q

How long should Adrenal Agents be used for?

A

SHORT TERM use to relieve inflammation during acute stages of illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which disease is associated with an excess of adrenals?

A

Cushings disease- moon face, central obesity, HTN, osteoporosis, hirsutism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What disease is caused by an adrenal insufficiency?

A

Addison Disease- confusion, hypotension, CV collapse, fatigue, limited ability to respond to infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How are adrenocortical agents dosed for children?

A

Determined by severity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What should be monitored very closely for children taking Adrenocortical Agents?

A

Growth and development b/c can cause retardation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When should Adrenocortical Agents be taken?

A

In the mornings between 8 & 9 am

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T/F Alternative feeding methods should be implemented for breastfeeding mothers on Adrenocortical Agents

A

TRUE- can cross placenta & enter breastmilk and harm baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are signs of an Adrenal Crisis

A

physiological exhaustion
hypotension
fluid shift
shock and even death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tx for an adrenal crisis

A

massive infusion of replacement steroids

constant monitoring & life support procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are common Glucocorticoid medications?

Also referred to as steroids

A
end in "-sone" 
Betamethasone
budesonide 
cortisone 
dexamethasone 
hydrocortisone 
methylprednisolone
prednisolone 
prednisone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the action of Glucocorticoids?

A

Initiate many complex reactions responsible for anti-inflammatory and immunosuppressive effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which Glucocorticoids have some mineralocorticoid activity?

A

Hydrocortisone
cortisone
prednisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are Glucocorticoids indicated for?

A

Short term tx of many inflammatory disorders- RA, COPD
relief of discomfort
give body a chance to heal from effects of inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Contraindications for Glucocorticoids

A

known allergy
acute infection- b/c have immunosupressant effects
lactation- enters breast milk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cautions for Glucocorticoids

A

diabetes- will increase blood glucose levels

acute peptic ulcer- they are stress hormones and can exacerbate a peptic ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ADE of Glucocorticoids

A

H/A, insomnia, psychosis, GI upset, HF, fluid retention, increase blood glucose, osteoporosis, frail skin, growth retardation in children, diabetes, Cushing syndrome, impaired wound healing, aggravating/ masking of infections

17
Q

Drug/ Drug interactions of Glucocorticoids

A

increase in drug when combined with erythromycin, ketoconazole, troleandomycin
DECREASE in drug when given w/ salicylates, barbiturates, phenytoin, rifampin

18
Q

What needs to be assessed for a pt taking Glucocorticoids?

A

weight- fluid retention
temp- infection
orientation and affect- CNS
serum electrolytes

19
Q

T/F Stop Glucocorticoids abruptly to minimize ADE

A

FALSE- taper in order to allow adrenal glands to wake back up

20
Q

Why can’t pts taking Glucocorticoids have live virus vaccines?

A

b/c increase risk for infection d/t immunosuppression

21
Q

Prototype for Glucocorticoids

A

Prednisone

22
Q

Common Mineralocorticoids

A

cortisone
fludrocortisone
hydrocortisone

23
Q

Action of Mineralocorticoids

A

effects on electrolytes, works very similarly to aldosterone but not given as a medication
hold sodium & water in the body
Causes excretion of potassium by action on the renal tubule

24
Q

When are Mineralocorticoids indicated?

A

replacement therapy in primary and secondary adrenal insufficiency [addisons]

25
Contraindications of Mineralocorticoids
b/c it acts like aldosterone, anything that can exacerbate CV diseases known allergy, hypertension, CHF, cardiac disease
26
Cautions for Mineralocorticoids
pregnancy, infection, high sodium intake- hypernatremia will occur since it keeps sodium and water in the body
27
ADE of Mineralocorticoids
increase fluid volume d/t sodium retention | hypokalemia d/t too much potassium secretion
28
Drug/ drug interactions with Mineralocorticoids
decrease effectiveness with salicylates, barbituates, hydantoins, rifampin, and anticholinesterases
29
Why are Mineralocorticoids used only in conjunction with appropriate glucocorticoids
To maintain proper electrolyte balance
30
What are signs of Mineralocorticoids overdose?
excessive weight gain, edema, hypertension, cardiomegaly
31
Why do you increase the Mineralocorticoids dose during times of stress?
Because there is a demand for stress hormones?
32
Mineralocorticoid prototype
Fludrocortisone