Exam #2 Concept: Glucocorticoids / Mineralocorticoids

Corticosteroids

Center of adrenal glands: Medulla -> epi and norepi

Outer later: cortex -> gluco and mineral corticoids

Glucocorticoids

-Anti inflammatory

- Decrease movement of WBCs to inflamed areas

- maintain normal BP

- glucose, protein, and fat metabolism

Mineralocorticoids

- maintain BP control

- act on distal renal tubules

- regulate fluid and electrolytes (Na&H)

- balance pH in the blood

- aldosterone most common, naturally occuring

MOA of Prednisone

Anti inflammatory effects, immunosuppressant

Prednisone

- Increased glucogenesis

- Catabolism of proteins

- Redistribution of fat to central body

- Salt and water retention -> HTN and edema

- Prevent organ transplant rejection -rheumatoid arthritis, ulcerative colitis, addison's disease, COPD/Asthma, allergy, arthritis

Contraindications of Prednisone

Systemic fungal infections, administer live or attenuated virus vaccines

With Prednisone, use cautions in pts with

HTN

GI disorders

Myasthenia Gravis

Diabetes

Osteoporosis

Renal insufficiency

Pregnancy

Lactation

Indications for Fludrocortisone

addison's disease

MOA of Fludrocortisone

Enhances reabsorption of sodium and excretion of potassium and hydrogen in smaller doses

Adverse effects of Fludrocortisone

Increased BP

Hyperglycemia

Increased ICP

Contraindications for Fludrocortisone

System fungal infection

Pre-existing cardiac disease

Pregnancy category C

Nursing Considerations for Fludrocortisone

-Assess BP & Fluid and Electrolytes

-Emphasize diet high in potassium and moderate in sodium -> reduce risk in HTN, weight gain, and edema.

- Give with food -> decrease in GI upset

- Avoid alcohol, NSAIDs, and caffeine