Steroids/liver LC

hydrocortisone

B: cortes

hydrocortisone class

mineralcorticosteroid

hydrocortisone indication

acute adrenal crisis

hydrocortisone dose

100mg IV → 50mg IV q6h

hydrocortisone adjustments

renal: no hepatic: yes

hydrocortisone ADR

endocrine: hyperglycemia (monitor: Sr glucose)

prednisone

B: rayos/intensol

prednisone class

glucocorticoid

prednisone indication

anti-inflammatory/ adrenal insufficiency

prednisone dose

5-60mg po qd

prednisone adjustments

renal: no hepatic: yes

prednisone ADR

endocrine: hyperglycemia (monitor: Sr glucose)

dexamethasone

B: decadron/hemady

dexamethasone class

glucocorticoid

dexamethasone indication

cerebral edema

dexamethasone dose

10mg IV → 4mg q6h

dexamethasone adjustments

renal: no hepatic: yes

dexamethasone ADR

psychiatric: psychosis (monitor: mental status)

fludrocortisone

B: florinef

fludrocortisone class

mineralocorticoid

fludrocortisone indication

primary adrenal insufficiency

fludrocortisone dose

0.05-2mg po qd

fludrocortisone adjustments

renal: no hepatic: yes

fludrocortisone ADR

CV: htn/edema (monitor: BP and wgt)

Spironolactone

B: Aldactone

Spironolactone class

aldosterone agonist

Spironolactone indication

HFrEF

Spironolactone dose

12.5-25mg po qd

Spironolactone adjustments

renal: yes hepatic: no

Spironolactone ADR

endocrine: gynecomastia (monitor: breast exam/history)

ketoconazole

B: nizoral

ketoconazole class

antifungal

ketoconazole indication

systemic fungal infections

ketoconazole dose

200mg po qd

ketoconazole adjustments

renal: no hepatic: yes

ketoconazole ADR

GI/hepatic: fulminant hepatotoxicity (monitor: LFTs)

lactulose

B: constulose/enulose

lactulose class

osmotic laxative

lactulose indication

hepatic encephalopathy

lactulose dose

titrate to 2-3 soft stools/day

lactulose adjustments

renal and hepatic: no

lactulose ADR

GI/hepatic: severe diarrhea/dehydration (monitor: fluid/electrolytes)

rifaximin

B: xifaxan

rifaximin class

rifamycin

rifaximin indication

prevent recurrent hepatic encephalopathy

rifaximin dose

550mg po bid

rifaximin adjustments

real: no hepatic: yes

rifaximin ADR

hem/immunologic: hypersensitivity (monitor: rash/airway)

nadolol

B: corgard

nadolol class

nonselective beta blocker

nadolol indication

htn

nadolol dose

40mg po qd

nadolol adjustments

renal: yes hepatic: no

nadolol ADR

CV: bradycardia (monitor: HR/BP)

propanolol

B: inderal

propanolol class

nonselective BB

propanolol indication

htn

propanolol dose

80-160mg/day po

propanolol adjustments

renal: no hepatic: yes

propanolol ADR

pulmonary: bronchospasm (monitor: respiratory status)

carvedilol

B: coreg

carvedilol class

alpha/beta blocker

carvedilol indication

HFrEF

carvedilol dose

3.125mg po bid

carvedilol adjustments

real: no hepatic: yes

carvedilol ADR

pulmonary: bronchospasm (monitor: respiratory status)