Test 2 Steroids Flashcards
Westcort®
- hydrocortisone valerate
- potent
- topical -> poison ivy, contact dermatitis
- relief itching or skin inflammation
- caution with dermatological infections (ex. fungal infections)
- ointment or cream 0.2%
Cortef®, Cortenema®
- hydrocortisone
- oral: long term use for patients who do not produce cortisone
- enema: used for digestive hyper-immune diseases
Solu-Cortef®
- hydrocortisone
- Endocrine disorder / inflammatory disorders
- Systemic injectable
Deltasone®
- prednisone
- Treatment of allergic & inflammatory diseases
- tapered doses for allergic reactions
- Metabolized to prednisolone
- 5-60mg/day
Orapred®
- prednisolone
- Treatment of allergic & inflammatory diseases
- pay attention to solution concentration
Medrol®
- methylprednisolone
- Treatment of allergic and inflammatory diseases
- 4mg dosepak
- common side effect: insomnia
Solu-Medrol®
- methylprednisolone
- acute treatment of allergic & inflammatory diseases
- systemic injection
- used in ER
Decadron®
- dexamethasone
- Treatment of allergic & inflammatory diseases and asthma
- Note concentration with liquid dosage form 1 mg/mL vs. 0.5mg/5 mL
- potent
- dosepak not used often
Celestone®
- betamethasone
- potent
- Treatment of allergic & inflammatory diseases
- Topical and injectable dosage forms
- Topical foam, injectable suspension
Kenalog®
- triamcinalone
- inflammation
- injection and cream
- doctors use this with special formulations
Nasacort AQ®
- triamcinalone
- Chronic treatment of allergic rhinitis
- 2 sprays in each nostril daily
Flonase®
- fluticasone propionate
- Flonase Allergy is an OTC product (2 sprays in each nostril daily for a week and taper down to 1-2 sprays daily)
- prescription: may start with loading dose: ii sprays in each nostril BID, down to ii sprays each nostril QD
- Therapeutic effects are not seen immediately
- suspension: shake well before use
Veramyst ®
- fluticasone furoate
- different ester form of fluticasone
- Rx only
- used for allergic rhinitis
- Therapeutic effects are not seen immediately
- suspension: shake well before use
- 2 sprays in each nostril daily
Flovent ® MDI
- fluticasone
- Chronic treatment of asthma
- Therapeutic effects are not seen immediately
- high potency
- 3 strengths: 44, 110, 220 mcg
Advair ®
- salmeterol and fluticasone
- Steroid & Long-Acting-Beta-2 agonist combination
- chronic treatment of asthma: one puff BID 150/50, 250/50, 500/50
- COPD: one puff BID 250/50
Symbicort ®
- budesonide and formoterol
- MDI
- Steroid & Long-Acting-Beta-2 agonist combination
- Chronic treatment of asthma: start at 80/4.5 strength, after 2 wk increase to higher strength if need
- Chronic treatment of COPD: 160/4.5 mg
- 2 inhalations BID
Pulmicort®
- budesonide
- Chronic treatment of asthma
- Available as a solution for nebulization Pulmicort respules (only steroid that has a nebulizer solution )
- BID dosing
Rhinocort AQ®
- budesonide
- Allergic rhinitis
- for chronic treatment
- there is a OTC product
- start with two sprays daily then decrease to one spray in each nostril daily
Principles of Asthma treatment
- prevent symptoms by reducing inflammation
- must be taken daily
- do not expect quick relief
- acute / rescue meds used to treat active asthma attack or bronchospasm
key indicators for considering diagnosis of asthma
- wheezing
- history of: cough, wheeze, chest tightness, diff. breathing
- symptoms occur / worsen in the presence under certain circumstances
- symptoms occur / worsen at night
possible asthma if symptoms occur / worsen in the presence of these conditions
- Exercise
- Viral infection
- Animals with fur or hair
- House-dust mites (in mattresses, pillows, upholstered furniture, carpets)
- Mold
- Smoke (tobacco, wood)
- Pollen
- Changes in weather
- Strong emotional expression (laughing or crying hard)
- Airborne chemicals or dusts
- Menstrual cycles
Goals of therapy to achieve asthma control
♦ Prevent chronic and troublesome symptoms
♦ Require infrequent use (≤2 days a week) of inhaled SABA for quick relief of symptoms
♦ Maintain (near) “normal” pulmonary function
♦ Maintain normal activity levels
♦ Meet patients’ and families’ expectations of satisfaction with asthma care
♦ Prevent recurrent exacerbations of asthma and minimize the need for ED visits
♦ Prevent progressive loss of lung function; for children, prevent reduced lung growth
♦ Provide optimal pharmacotherapy with minimal or no adverse effects
What are common side effects with steroids?
♦ short-term - insomnia - upset stomach (take with food) - increased appetite -> weight gain ♦ long-term - increased blood pressure / sugar - moon face - osteoporosis - decrease growth of children - increased susceptibility to infections - adrenal suppression - peptic ulcer disease
Qvar®
- beclomethasone
- inhaled corticosteroid
- for chronic asthma
- 40/320 inhale BID
Beconase AQ ®
- beclomethasone
- nasal spray steroid
- for rhinitis
- not immediate effect
- 1-2 sprays each nostril BID
Elocon ®
- mometasone
- topical cream, ointment, lotion
- Dermatoses, rashes, allergic reaction
- apply sparingly once daily
Nasonex®
- mometasone
- steroid
- allergic rhinitis
- chronic
- 2 sprays each nostril daily
Florinef®
- fludrocortisone
- mineral corticosteroid effect
- Promotes increased reabsorption of sodium and loss of potassium from kidneys
- used for Addison’s Disease
- minimize the development of hyperkalemia
- chronic condition
- watch for edema
- 0.1 mg daily
What is one thing to keep in mind when considering steroid treatment?
effects will not be seen immediately; can take days to start seeing effect and weeks to see full effect
Inhaled corticosteroids
used as maintenance therapy to prevent inflammation that leads to bronchospasm
Nasal steroids
used as maintenance therapy to prevent symptoms of allergic rhinitis
Burst systemic corticosteroid therapy
indicated for treatment of acute inflammation or allergic reaction
Chronic systemic corticosteroid therapy
indicated for chronic inflammatory conditions or endocrine disorders
