Adrenocortical Agents - General

Question 1

Indications for use of adrenal agents

Answer 1

• Widely used to suppress the immune system

- Short-term use to relieve inflammation during acute stages of illness

Question 2

Adrenal excess

Answer 2

-Cushing disease: Symptoms include moon-like face, central obesity, HTN, protein breakdown, osteoporosis, hirsutism

Question 3

Adrenal insufficieny

Answer 3

-Addison disease: symptoms include confusion, hypotension, CV collapse, fatigue, limited ability to respond to infection

Question 4

Considerations for children

Answer 4

• Dose is determined by severity of condition not age or weight
• Monitor growth and development
• Protect against infection and injuries

Question 5

Considerations for adults

Answer 5

• Take in the AM
• Taper the medication; do NOT stop abruptly
• Check OTC meds for corticosteroids
• Protect against infection and injuries
• Can cross breastmilk and placenta

Question 6

Considerations for older adults

Answer 6

• More likely to experience ADE

- More likely to have conditions that are impacted by corticosteroids (DM, HF, osteoporosis)

Question 7

Types of corticosteroids

Answer 7

• Androgens
• Glucocorticoids
• Mineralcorticoids

Question 8

Androgens

Answer 8

-Male and female sex hormones

Question 9

Causes of adrenal insufficiency

Answer 9

• Does not produce enough ACTH
• Adrenal glands are not able to respond to ACTH
• Adrenal gland is damaged
• Secondary to surgical removal of the gland
• Prolonged use of corticosteroids

Question 10

Actions of adrenocortical hormones

Answer 10

• Increase blood volume (aldosterone effect)
• Cause the release of glucose
• Slow rate of protein production (reserves energy)
• Block activities of the inflammatory and immune systems

Question 11

Adrenal crisis

Answer 11

• S/S: Physiological exhaustion, hypotension, fluid shift, shock and even death
• Treatment: Massive infusion of replacement steroids, constant monitoring and life support measures