Steriods Flashcards
Steroids hormones
Glucocorticoids
Mineralcorticoids
Androgens
Glucocorticoids
Influence carb metabolism
Cortisol most important
Hydrocortisone (cortef)
Mineral corticoids
Regulate salt and water balance
Aldosterone most important
Fludrocortisone
Androgens
Contribute to expression of sexual characteristics
Negative effects of glucocorticoids
Osteoporosis
Muscle weakness and atrophy
Stress adaption interference
Inhibit action of growth hormone
Prototype of glucocorticoids
Hydrocortisone (cortef)
MOA of hydrocortisone
Produces multiple glucocorticoid and mineralocorticoid effects
Adverse effects of hydrocortisone
Adrenal suppression , production of Cushing’s syndrome
Contraindication for hydrocortisone
Systemic fungal infection hypersensitivity
Dosage of hydrocortisone
25-30 mg bid by both
2/3 in morning (between 8 am and 9 AM)
1/3 in Afternoon dose around 4 (no later than 6 interferes with sleep)
If pt works night shift flip when they take it
Mineralcorticoids
Affect renal processing of NA, K and hydrogen
Aldosterone most important
Fludrocortisone
Teachings for steriods
Regular eye exam
Don’t take with alcohol and take oral doses with meals
Take any missed dose as soon as remembered
Limit sodium
Monitor sugar
Report blood or black stools mood
What can you take your steriods with to help with flavor
Juice, coco cola , coffee anything strong
Why should you not take steroid treatment and do something like the flu vaccine
Avoid getting flu shot because it interferes with body inflammatory response (and you need that when doing vaccines)
When you are a wk off then go get flu shot
What teaching is important with vaccines and chronic steroid use
Live vaccines may be a problem consult with doc
They may get something like the flu vaccine but it interrupts the inflammatory process and it may not be as strong
Main thing to know with steriods
Never stop abruptly
two things you should always have on hand when taking steriods
Medical alert ID and emergency kit
Dosage schedule for Fludrocortisone
PO every day 0.1-0.2
Once a day in the morning
What is a big thing that Fludrocortisone impacts?
Effects potassium (hypokalemia)
And fluid balance watch for fluid retention
If you are taking too much Fludrocortisone
Pt may be stimulated
Watch for wait gain, elevated BP
Psychosis ,edema CHF increase apetite . Severe insomnia and hypertension
When should you give Fludrocortisone
Give daily befor 0900 to mimic body’s natural rhythm
Important teaching with mineral corticoid/Fludrocortisone
Eat foods high in potassium
S/s of fluid overload
Daily weights
Corticosteroids
Methylprednisolone
Dexamethasone
Prednisone
The good of corticosteroids
Stop,control or reduce inflammatory response (local or systemic) in any part of the body by suppressing the immune system
The bad of corticoid steroid use
Slow deterioration of the bodu
The ugly of corticoid steriods use
Watch for edema , peptic ulcers, delayed wound healing , osteoporosis and infections
