Corticosteroids Overview and Administration

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.
• 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.
• 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.

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.