Steroids

Steroids

• Dexamethasone

• Prednisone

• Methylprednisone

Dextamethasone action

stabilizes leukocytes lysosomal membranes; suppresses immune response; stimulates bone marrow, and influences protein, fat, and carb metabolism

Dexamethasone indicaiton

anti inflammatory, cerebral edema, immunosuppresive, shock

Dexamethasone key s/e

hypoglycemia, seizures, cerebral edema, pancreatitis, hypokalemia, hypocalcemia, arrhythmias, thromboembolism

Dexamethasone nursing considerations

• monitor pt weight, BP, and electrolyte levels

• monitor for cushing’s: moon face, buffalo hump, trunchal obesity, HTN

• inspect pt skin for petechiae

• adjust to lowest effective dose

Dexamethasone data needed to give the drug

• Monitor LFTs, CBC, electrolyte panel

• monitor for glucose levels

• assess skin

• monitor thyroid levels

Prednisone action

stabilize leukocyte lysosomal membranes; suppresses immune response; stimulates bone marrowm and influences proteins, fat, and carb metabolism

Prednisone Indication

severe inflammation, acute exacerbation of MS

Prednisone key s/e

depression, fever, insomnia, psychotic behavior, pulmonary edema, HF, bradycardia, cardiac arrest, fat embolism, thromboembolism, pancreatitis, neutropenia, hypokalemia, hypocalcemia, adrenal insufficiency

Prednisone nursing conisderations

• determine pt hypersensitivity to corticosteroids

• always adjust to lowest effective dose

• monitor BP, sleep patterns, and potassium levels

• weight pt daily

Prednisone data needed to give drug

• Monitor LFTs, CBC, electrolyte panel

• monitor glucose levels

• assess skin

• monitor thyroid levels

Methylprednisone action

stabilize leukocyte lysosomal membranes; suppresses immune response; stimulates bone marrowm and influences proteins, fat, and carb metabolism

Methylprednisone indication

severe inflammation or immunosuppression

Methylprednisone key s/e

insomnia, seizures, psuedotumor cerebri, cardiac arrest, HF<arrhythmias, thromboembolism, CV collapse, pancreatitis, hypokalemia, hypocalcemia, pulmonary edema, adrenal insufficiency

Methylprednisone nursing considerations

• monitor VS

• monitor for hypersensitivity

• use cautiously in older adults with GI ulceration or kidney disease, HTN, osteoporosis, diabetes, hypothyroidism, cirrhosis, diverticulitis, ulcerative colitis, etc.

Methylprednisone data needed to give drug

• Monitor LFTs, CBC, electrolyte panel

• monitor glucose levels

• assess skin

• monitor thyroid levels