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Corticosteriods – Nursing Pharmacology
Corticosteroids are a class of drug that are used to reduce inflammation in the body as well as to control overactive immune system activity and hormonal imbalances. Systemic corticosteroids are commonly given orally or through injection and their effects are multi-systemic. On the other hand, localized steroids are given topically, as drops, or inhaled to particularly act on an organ or organ system. Corticosteroids are widely used in different medical conditions.
Most of their uses are related to inflammatory regulation. Corticosteroids work through several mechanisms. Corticosteroid molecules diffuse to cell membranes and bind to glucocorticoid receptors. The binding causes a series of effects in the body cells which leads to the suppression in the synthesis of pro-inflammatory mediators which include macrophages, eosinophils, lymphocytes, mast cells, and dendritic cells.
Also, corticosteroids inhibit the action of phospholipase A2 which produces other inflammatory mediators. They may not occur all the time, although the likelihood of having such side effects may change depending on the dose and time the drug is taken.
Corticosteroids are highly associated with obesity and growth retardation in children. They can also predispose the person taking it to infections due to the suppression of immune system function. Sudden discontinuation of the medication can cause adrenal crisis which is the inability of the adrenal glands to cope with the supply due to sudden withdrawal. An increased risk of hypokalemia may occur when corticosteroids are administered with other medications that reduce potassium levels like diuretics, laxatives, high doses of certain antibiotics and insulin.
Caution is highly warranted as hypokalemia is greatly associated with dysrhythmia and heart failure. Also, corticosteroids given with anticholinesterase can cause severe weakness in individuals diagnosed with myasthenia gravis.
Other medical conditions require caution when a person is prescribed with corticosteroids such as the following:. However, these drugs also interact with other medications which changes effectiveness of corticosteroids. Ackley, B. Nursing diagnoses handbook: An evidence-based guide to planning care.
Louis, MO: Elsevier. Buy on Amazon. Gulanick, M. Ignatavicius, D. Medical-surgical nursing: Concepts for interprofessional collaborative care.
Silvestri, L. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.
This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. This site uses Akismet to reduce spam. Learn how your comment data is processed. Corticosteroids Nursing Implications Corticosteroids Nursing Pharmacology Corticosteroids are a class of drug that are used to reduce inflammation in the body as well as to control overactive immune system activity and hormonal imbalances. Nursing Stat Facts. Nursing Interventions for Corticosteroids.
To confirm the indication for administering corticosteroids. Previous allergic reaction to corticosteroids may render the patient unable to take them. Alternatives to corticosteroids should therefore be considered in case of allergy. Assess if the patient is pregnant or lactating. Very potent corticosteroids should be prescribed in caution to a pregnant woman or lactating mother as these drugs can potentially harm the fetus or newborn.
To check for any potential problems with administration, hydration, and absorption. To ensure that the right form of corticosteroids is given through the right route. Check for current medications that include diuretics, laxatives, high doses of certain antibiotics and insulin as these should be used cautiously with corticosteroids.
An increased risk of hypokalemia may occur when corticosteroids are administered with other medications that reduce potassium levels like diureticslaxatives, high doses of certain antibiotics and insulin. Check medical history for diabetes or myasthenia gravis. Corticosteroids can increase serum glucose levels.
Corticosteroids given with anticholinesterase can cause severe weakness in individuals diagnosed with myasthenia gravis. Administer corticosteroids in the morning with breakfast. To ensure optimal absorption and therapeutic action by corticosteroids. Educate the patient about the action, indication, common side effects, and adverse reactions to note when taking corticosteroids.
Instruct the patient on how to self-administer corticosteroids. For topical steroids, advise the lactating mother to wash off any steroid cream from the skin prior to feeding the baby. To ensure that the steroid is not ingested by the baby during breastfeeding.
Inform the patient not to have any live vaccine within 3 months after the course of corticosteroids. Corticosteroids may weaken the immune system. Taking NSAIDs and steroids may increase the risk for internal gastrointestinal bleeding and stomach ulcers. Advise the patient to rinse the mouth with water after using steroid inhalers.
Advise the patient to eat moderately while on steroids, especially when taking it for more than 3 weeks. Taking corticosteroids for less than 3 weeks poses little to no side effects. However, taking steroids for more than 3 weeks may increase appetite, leading to weight gain. Towards the end of the course of corticosteroids, inform the patient if the steroids need to be tapered down. Abruptly stopping some types of steroids such as prednisone may cause withdrawal symptoms such as fatigue, joint pain, lightheadedness, and dizziness.
Routinely check for the blood glucose level of the patient, especially if they are diabetic. Ask the patient to repeat the information about corticosteroids. To evaluate the effectiveness of health teaching on corticosteroids.
To ensure that the corticosteroids did not cause any electrolyte imbalance particularly hypokalemia or renal dysfunction. To check if the corticosteroids are effective or if the dose needs to be adjusted.
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This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. This site uses Akismet to reduce spam. Learn how your comment data is processed. Corticosteroids Nursing Implications Corticosteroids Nursing Pharmacology Corticosteroids are a class of drug that are used to reduce inflammation in the body as well as to control overactive immune system activity and hormonal imbalances.
Nursing Stat Facts. Nursing Interventions for Corticosteroids. To confirm the indication for administering corticosteroids.
Previous allergic reaction to corticosteroids may render the patient unable to take them. Alternatives to corticosteroids should therefore be considered in case of allergy.
Assess if the patient is pregnant or lactating. Very potent corticosteroids should be prescribed in caution to a pregnant woman or lactating mother as these drugs can potentially harm the fetus or newborn. To check for any potential problems with administration, hydration, and absorption.
To ensure that the right form of corticosteroids is given through the right route. Check for current medications that include diuretics, laxatives, high doses of certain antibiotics and insulin as these should be used cautiously with corticosteroids. An increased risk of hypokalemia may occur when corticosteroids are administered with other medications that reduce potassium levels like diuretics , laxatives, high doses of certain antibiotics and insulin.
Check medical history for diabetes or myasthenia gravis. Corticosteroids can increase serum glucose levels. Corticosteroids given with anticholinesterase can cause severe weakness in individuals diagnosed with myasthenia gravis. Administer corticosteroids in the morning with breakfast.
To ensure optimal absorption and therapeutic action by corticosteroids. Educate the patient about the action, indication, common side effects, and adverse reactions to note when taking corticosteroids.
Instruct the patient on how to self-administer corticosteroids. For topical steroids, advise the lactating mother to wash off any steroid cream from the skin prior to feeding the baby. To ensure that the steroid is not ingested by the baby during breastfeeding. Inform the patient not to have any live vaccine within 3 months after the course of corticosteroids.
Corticosteroids may weaken the immune system. Taking NSAIDs and steroids may increase the risk for internal gastrointestinal bleeding and stomach ulcers. Advise the patient to rinse the mouth with water after using steroid inhalers. Advise the patient to eat moderately while on steroids, especially when taking it for more than 3 weeks.
Taking corticosteroids for less than 3 weeks poses little to no side effects. However, taking steroids for more than 3 weeks may increase appetite, leading to weight gain. Towards the end of the course of corticosteroids, inform the patient if the steroids need to be tapered down.
Oral prednisone prevents the release of substances in the body that cause inflammation. It also suppresses the immune system. Methylprednisolone IV prevents the release of substances in the body that cause inflammation.
Methylprednisolone requires reconstitution before administration. See Figure 5. Fluticasone inhalers are used to prevent asthma attacks. In respiratory conditions, oral prednisone is used to control severe or incapacitating allergic conditions that are unresponsive to adequate trials of conventional treatment for seasonal or perennial allergic rhinitis, bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness, and drug hypersensitivity reactions.
Methylprednisolone IV is used to rapidly control these same conditions. Fluticasone is safe for 4 years and older. Prednisone and methylprednisolone are safe for all ages. Fluticasone can cause hoarseness, dry mouth, cough, sore throat, and oropharyngeal candidiasis. Patients should rinse their mouths after use to prevent candidiasis thrush.
Cardiovascular symptoms can include fluid retention, edema, and hypertension. CNS symptoms include mood swings and euphoria. GI symptoms can include nausea, vomiting, and GI bleed. In long- term therapy, bone resorption occurs, which increases the risk for fractures; the skin may bruise easily and become paper thin; wound healing is delayed; infections can be masked; and the risk for infection increases. Long-term corticosteroid therapy should never be stopped abruptly because adrenal insufficiency may occur.
Patients should be advised that corticosteroids are not used to treat an acute asthma attack. They can cause immunosuppression and suppress signs of infection. Corticosteroids can also cause an increase in blood glucose levels. Patients may experience weight gain, swelling, increased fatigue, bruising, and behavioral changes. Inhaler: Used to improve the control of asthma by reducing inflammation in the airways Hoarseness, dry mouth, cough, sore throat, and oropharyngeal candidiasis Corticosteroids prednisone Do not use if signs of a systemic infection.
Corticosteroids can be prescribed in a variety of routes. Fluticasone is an example of a commonly used inhaled corticosteroid; prednisone is an example of a commonly used oral corticosteroid; and methylprednisolone is a commonly used IV corticosteroid. Fluticasone is a locally acting anti-inflammatory and immune modifier. The nasal spray is used for allergies, and the oral inhaler is used for long-term control of asthma.
Fluticasone is also used in a combination product with salmeterol. It decreases the frequency and severity of asthma attacks and improves overall asthma symptoms. See Figures 5.
Oral prednisone prevents the release of substances in the body that cause inflammation. It also suppresses the immune system. Methylprednisolone IV prevents the release of substances in the body that cause inflammation.
Methylprednisolone requires reconstitution before administration. See Figure 5. Fluticasone inhalers are used to prevent asthma attacks.
In respiratory conditions, oral prednisone is used to control severe or incapacitating allergic conditions that are unresponsive to adequate trials of conventional treatment for seasonal or perennial allergic rhinitis, bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness, and drug hypersensitivity reactions.
Methylprednisolone IV is used to rapidly control these same conditions. Fluticasone is safe for 4 years and older. Prednisone and methylprednisolone are safe for all ages. Fluticasone can cause hoarseness, dry mouth, cough, sore throat, and oropharyngeal candidiasis. Patients should rinse their mouths after use to prevent candidiasis thrush. Cardiovascular symptoms can include fluid retention, edema, and hypertension.
CNS symptoms include mood swings and euphoria. GI symptoms can include nausea, vomiting, and GI bleed. In long- term therapy, bone resorption occurs, which increases the risk for fractures; the skin may bruise easily and become paper thin; wound healing is delayed; infections can be masked; and the risk for infection increases.
Long-term corticosteroid therapy should never be stopped abruptly because adrenal insufficiency may occur. Patients should be advised that corticosteroids are not used to treat an acute asthma attack. They can cause immunosuppression and suppress signs of infection. Corticosteroids can also cause an increase in blood glucose levels. Patients may experience weight gain, swelling, increased fatigue, bruising, and behavioral changes. Inhaler: Used to improve the control of asthma by reducing inflammation in the airways Hoarseness, dry mouth, cough, sore throat, and oropharyngeal candidiasis Corticosteroids prednisone Do not use if signs of a systemic infection.
May increase blood glucose levels Used to control severe or incapacitating allergic or respiratory conditions CV: fluid retention, edema, and hypertension. Skip to content Corticosteroids can be prescribed in a variety of routes. Mechanism of Action Fluticasone is a locally acting anti-inflammatory and immune modifier. Indications for Use Fluticasone inhalers are used to prevent asthma attacks.
Nursing Considerations Across the Lifespan Fluticasone is safe for 4 years and older. Wolters Kluwer. National Library of Medicine in the public domain. Previous: 5. Next: 5. Share This Book Share on Twitter. Nasal spray: Used for management of the nasal symptoms of perennial nonallergic rhinitis Inhaler: Used to improve the control of asthma by reducing inflammation in the airways.
Hoarseness, dry mouth, cough, sore throat, and oropharyngeal candidiasis. Do not use if signs of a systemic infection When using more than 10 days, the dose must be slowly tapered May increase blood glucose levels. Used to control severe or incapacitating allergic or respiratory conditions. Used to rapidly control severe or incapacitating allergic or respiratory conditions, in sepsis to reduce systemic inflammation, and to treat adrenal insufficiency.
PREDNISOLONE (pred-niss'oh-lone) Delta-Cortef, Prelone PREDNISOLONE ACETATE Econopred, Key-Pred, Pred Forte, Predcor PREDNISOLONE SODIUM PHOSPHATE. NURSING IMPLICATIONS. Assessment & Drug Effects. Establish baseline and continuing data regarding BP, I&O ratio and pattern, weight. Effects of Drug on Patient: Common Uses: Arthritis, asthma, colitis, severe allergies, skin diseases, lupus, cancer, and endocrine disorders. Prednisone may. Corticosteroids Nursing Implications. Corticosteroids Nursing Pharmacology. Corticosteroids are a class of drug that are used to reduce inflammation in the. Corticosteroids can be prescribed in a variety of routes. Fluticasone is an example of a commonly used inhaled corticosteroid; prednisone is an example of a. Louis, MO: Elsevier. However, taking steroids for more than 3 weeks may increase appetite, leading to weight gain. Long-term corticosteroid therapy should never be stopped abruptly because adrenal insufficiency may occur. Ackley, B.Conserve este prospecto, ya que puede tener que volver a leerlo. Contenido del prospecto: 1. Benzac contiene propilenglicol Este medicamento contiene 40 mg de propilenglicol (E-1520) en cada gramo.
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