Drugs Affecting Corticosteroid Levels

Front 1

Glucocorticoids
Prednisone (deltasone, Prednicot)

Back 1

I: Anti-Inflammatory, Immunosuppressive, Dilation
C: Fungal Infections, Vaccines
A: bad mood insomnia, menstrual changes, hyperglycemia
D: opposes anticoagulants
Min: other signs of infections, PUD (h2), rinse mouth Max: AM dose, adjust with illness
PT: adrenal crisis if stopped fast, tell other HCP

Front 2

Mineralocorticoids
Fludrocortisone (Florinef Acetate)

Back 2

I: Addison's
C: fungal, cardiovascular ( ^ na+ and decrease K+)
A: Na+ retentions and K+ excretion HTN, edema, cardiomegaly
D: oppose oral anticoagulants, salicylates, loops
Min: BP, fluid, electrolytes, diet high in K+ low in Na+
Max: tolerance can occur
NC: don't stop fast, report weight gain, high BP, muscle weakness, signs of Infections, labs I's and O's, HCP's

Front 3

Steroid Hormone Antagonist
Aminoglutethimide (cytadren)

Back 3

I: Cushing's
C: serious infections
A: blood dyscrasias, low BP, skin rash
D: decrease warfarin, digoxin, theophylline
Mx: injury, illness, or infections = adrenocortical insuff.
Mn: OPHO, HPO, caution w/ driving and machinery.
NC: weight, height, I's & O's, hydration, immune, labs, electrolytes, edema.

Front 4

Growth Hormone
Somatropin

Back 4

I: GH replacement
C: closed epiphyses
A: HTN, bone joint muscle pain, edema, rhinitis, hypothyroidism, hyperglycemia,
D: steroid or hormones ^ epiphyses closure
Max: hypothyroidism may develop, dialysis in the AM
Min: report development of a limp hip or knee pain
NC: monitor glucose, thyroid.

Front 5

Posterior Hormone Regulators
Desmopressin

Back 5

I: DI, nocturnal enuresis hemophilia A
C: Fluid and Electrolyte Imbalance, Coronary artery disease
A: AB pain, nasal congestion, rhinitis, facial flushing
D: Carbamazepine. ChlorpromazineNSAIDS (potentiate the desmopressin)
Max: weight, BP, electrolytes and urine specific gravity, . (watch decreasing sodium levels and water toxicity)
Min: pre-existing cardiovascular or renal disorders
NC: monitor I's & O"s , urines specific gravity, and weight

Front 6

Thyroid Drugs
Levothyroxine (Synthroid, T4, Levothroid)

Back 6

I: Hypothyroidisn
C: Thyrotoxicosis, acute MI
A: HTN, tacyC, arrhythmias sweating and heat intolerance (Overmedications lower dosage)
D: anticoagulants( increases the affect), (decrease effects of digoxin) , hypoglycemic agents, grapefruit juice
Max: : breakfast at the same time , weight weekly and report wt. gain, increase fluid and fiber, separate other drugs.
Min: monitor BS, don't take w/ iron or calcium, stay with same med
NC: monitor BS thyroid levels, over medication, Report HR >100

Front 7

Anti-thyroid Compounds
Mathimazole MMI

Back 7

I: hyperthyroidism
C: HSN, preggo
A: agranulocytosis and aplstic anemia, rash, joint swelling
D: Beta blockers and Theop. (^ effects), opposes Wafarin
Max: same time q day or qh8, take w. food, hydrate, stay w. same drug
Min: blood test, bone marrow function, avoid food high in iodine, thyroid levels
NC: report intolerance to temp changes (overmedication)

Front 8

Anti-hypercalemic
Calcitonin

Back 8

I: Paget's
C: salmon, preggo C
A: flushing face, rash, rhinitis, arrhy.
D: calcium supplement, antacids, VitD (^ hypercalcemia) theop ^ bone reabsorption
Max: give by injection
Min: report muscle twisting and pain, nasal problems
NC: monitor calcium and urine

Front 9

Antihypocalcemic
Calcitrol

Back 9

I: dietary calcium
C: ppl at risk for hypercalcemia, or hypercaluria
A: constipation and bone pain, dry mouth
D: thiazide diuretics (risk of hypercalcemia)
Max: monitor cal. phosphate and BUN
Min: dialysis pts. should avoid mag. containing antacids

Front 10

Insulin
Regular (Humulin R)

Back 10

Hypoglycemia
Lipoatrophy (rotate spots)
Dobutamine, thiazide diuretics decrease effects, Alcohol, beta blockers, niacin, MAOIs and tetracycline ^ the effects
Onset: 30 to 60 min

Front 11

Rapid acting
Novolog and Humulog

Back 11

onset: 5 to 15 min
shot duration
pt. must eat a meal after injection
no IV but a SC pump

Front 12

Long acting
Lantus, levemir, detemir)

Back 12

24 hours no peak time, take at bedtime
do not mix

Front 13

Glyburide (DiaBeta)

Back 13

Sulfonylures
C: cross sensitivity with loops and sulfamide antibx
A: hypoglycemia, metallic taste, photsensativity, hypernatremia, SIADH
D: alcohol, beta blockers and antacids increase the effects (hypoglycemia)
Max; in the AM at bfast or 1st meal of the day
Min: monitor BS levels, monitor renal or haptic impairment, sxs of hypoglycemia

Front 14

Non Sulfonylureas
Metformin (Glucophage)

Back 14

I: delays digestion of carbs
C: hepatic disease, black box for renal impairment lactic acidosis
A: wt. loss ab discomfort, metallic taste, blood dys.
D: contrast media and sulfonylureas = hpogly
Max: 2x at bfast and dinner,
Min: avoid alcohol

Front 15

Acarbose (precose)

Back 15

must be taken with first bite of meal to prevent hyperglycemia
C: IBD and liver cirrhosis

Front 16

Glucagon (GlucaGun)

Back 16

I: 1st line for hypoglycemia
C: HSN
A: hpo respiratory depression, hypoK+, N&V
D: oral anticoagulants increase its affects
Max: propel admin, ways to prevent hypoglycemia
Min: sxs of hyperglycemia and hypoglycemia