Endocrine Drug

Question 1

Prednisone - Class

Answer 1

• Systemic Corticosteroids
• Treat a variety of inflammatory diseases

Question 2

Prednisone - MOA & Indication

Answer 2

• MOA: Anti-inflammatory & immunosuppressive effects
• Indication: Inflammatory & allergic disorders

Question 3

Prednisone - Contraindications

Answer 3

• Acute infection
• Diabetes mellitus
• Acute peptic ulcers
• CHF
• Older adult

Question 4

Prednisone - Drug/Drug

Answer 4

• Quinolone antibiotics
• NSAIDs
• Immunosuppressants
• Live vaccines

Question 5

Prednisone - Adverse Effects

Answer 5

• Short Term:
  > gastric irritation
  > immunosuppression
  > edema (HTN, weight gain)
  > insomnia
  > appetite incr
  > masks s/s of infection
  > steroid psychosis
• Long Term:
  > Cushing’s syndrome
  > hypernatremia
  > hypokalemia
  > growth suppression (children)
  > adrenal suppression

Question 6

Cushing’s Syndrome

Answer 6

• Weight gain/redistribution of fat
  > moon face
  > buffalo hump
  > pendulous abdomen & stretch marks
• Hyperglycemia
• Osteoporosis
• HTN
• Muscle atrophy (arms/legs)
• Bruise easily/purpura
• Skin thins/poor healing

Question 7

Corticosteroid Assessment

Answer 7

• Physical exam focused on cardiac, resp, neuro, s/s infection
• Monitor VS closely for HTN, fever
• Labs: CBC, creatinine/BUN, electrolytes (Na/K), BG

Question 8

Corticosteriods Interventions

Answer 8

• Admin in morning (norm peak duiernal concentration) & multiple doses in equal intervals (homeostasis)
• Take w/ food
• Taper dose when discontinuing long term use or from high doses
• Do not give live vaccines when immunosupprressed (risk of infection)
• Avoid unnecessary exposure to infection
• Educate: avoid infections, taking dose as appropriate, s/s adrenal crisis, managing AEs