Podcast
Questions and Answers
What is a potential risk of using corticosteroids in patients with systemic infections?
What is a potential risk of using corticosteroids in patients with systemic infections?
Which of the following conditions should corticosteroids be avoided in?
Which of the following conditions should corticosteroids be avoided in?
What should be monitored in patients receiving long-term corticosteroid therapy?
What should be monitored in patients receiving long-term corticosteroid therapy?
Which drug class inhibits the enzymes COX-1 and COX-2?
Which drug class inhibits the enzymes COX-1 and COX-2?
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How should NSAIDs be administered to minimize gastrointestinal irritation?
How should NSAIDs be administered to minimize gastrointestinal irritation?
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Which of the following should not be administered to children who have the flu?
Which of the following should not be administered to children who have the flu?
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What should be avoided when administering corticosteroids to monitor their effects?
What should be avoided when administering corticosteroids to monitor their effects?
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What is a common adverse effect associated with the long-term use of corticosteroids?
What is a common adverse effect associated with the long-term use of corticosteroids?
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Study Notes
Corticosteroids
- Drug examples: betamethasone, cortisone, dexamethasone, hydrocortisone, methylprednisolone, prednisolone, prednisone, triamcinolone
- Mechanism of action: Suppress the entire immune response, inhibiting prostaglandin production, histamine release, and phagocyte and lymphocyte activity involved in inflammation.
- Contraindications: Systemic infections, systemic fungal infections, concurrent live virus vaccines, PUD, glaucoma or cataracts, diabetes, psychiatric disorders.
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Administration considerations:
- Obtain baseline vital signs and weight; monitor routinely during therapy.
- Avoid abrupt discontinuation.
- Administer as ordered.
- For daily or alternate-day dosing, administer in the morning to minimize adrenal cortisone suppression.
- Use with caution in pregnant women.
- For IM administration, give deep IM injections to avoid atrophy or abscess, avoid the deltoid muscle.
- Long-term monitoring: Blood glucose levels, mood changes, edema, signs of Cushing syndrome.
- Adverse effects: Increased susceptibility to infection, masking of early infection signs, hyperglycemia, hypokalemia, hypertension, signs of heart failure, peptic ulcer formation, potential GI hemorrhage.
NSAIDs
- Drug examples: diclofenac, etodolac, fenoprofen, ibuprofen, indomethacin, ketorolac, meloxicam, nabumetone, naproxen, oxaprozin, piroxicam
- Mechanism of action: Inhibit COX-1 and COX-2 enzymes to decrease prostaglandin precursor production.
- Administration considerations: Administer with food or milk. Use with caution in pregnant women.
- Contraindications: Peptic ulcer disease, concurrent anticoagulant use.
- Monitoring: Effectiveness when co-administered with diuretics.
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Special considerations:
- Aspirin may increase clotting time.
- Use cautiously in older adults due to reduced kidney and liver function.
- Do not give aspirin to children with flu, flu-like symptoms, or chickenpox.
Salicylates
- Drug example: aspirin
- Mechanism of action: Inhibits COX-1 and COX-2 enzymes that produce prostaglandin precursors; also an antipyretic.
Selective COX-2 Inhibitors
- Drug example: celecoxib
- Mechanism of action: Only inhibit COX-2 enzymes, decreasing prostaglandin precursor production while minimizing side effects.
Natural Therapies
- Drug example: fish oil (omega-3 fatty acids)
- Mechanism of action: Contain EPA and DHA, which inhibit the conversion of arachidonic acid to prostaglandins.
- Drug interactions: May interact with anticoagulants, aspirin, and other NSAIDs.
- Adverse effects: Potential for bruising and nosebleeds.
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Description
Explore the essential aspects of corticosteroids, including drug examples, mechanisms of action, and contraindications. This quiz will also cover administration considerations and long-term monitoring practices necessary for safe and effective use of these medications.
