Steroids Flashcards
Indication for systemic steroids
- Autoimmune disorders (SLE, RA, polymyalgia rheumatica, Crohn’s)
- Asthma/COPD/Pneumonia
- Anaphylaxis
- Cancer
- Transplant Medicine
- Steroid deficient states (Addison’s, adrenal insufficiency)
- Maturation of fetal lungs
Contraindications for systemic steroids
active serious infection (viral, fungal)
caution with diabetics b/c can cause hyperglycemia
systemic steroids MOA
suppresses immune reactions/inflammatory response
Examples of systemic steroids
- Prednisone
- Methylprednisolone (medrol)
- Dexamethasone
Patient Education for systemic steroids
- requires gradual taper to prevent adrenal suppression
2. important to take medication as directed
systemic steroids side effects
- hyperglycemia
- weight gain and swelling
- psychiatric (depression, mania, psychosis, euphoria, insomnia, mental confusion)
- GI bleeding
- HTN
- Infections, delayed wound healing
- thin skin, stretch marks, acne, facial flushing
- cataracts, glaucoma
- muscular wasting, pain
- adipose distribution (buffalo hump, central obesity)
- osteoporosis, avascular necrosis
- cushing syndrome
- suppression of growth (short stature)
- adrenal suppression
What do you need to monitor when giving systemic steroids and why?
- WBC
2. can cause increase in WBC so makes it difficult to determine whether high WBC is from infection of steroids
Drug Interactions of systemic steroids
NSAIDs –> higher GI bleed risk
Signs of Cushing’s syndrome
- moon facies
- central obesity
- buffalo hump
- supraclavicular fat collection
what labs must you monitor with giving long-term steroids?
WBC because steroids can increase WBC count
Do CBC!!
Effects of steroids on labs
Increases 1. serum glucose 2. muscle breakdown 3. neutrophil count (immature) 4. Ca mobilization from bone Decreases 1. WBC 2. cell division 3. phospholipase A2
