• Mineralocorticoids
• Glucocorticoids
Drug Class: Mineralocorticoids actions
•Florinef (fludrocortisone)
•ACTIONS
•Adrenal corticosteroid that affects fluid and electrolyte
balance by acting on the distal renal tubules, causing
sodium and water retention and potassium and hydrogen
excretion.
Mineralocorticoids •USES
•Used in combination with glucocorticoids to replace
mineralocordicoid activity in patients who suffer from
adrenocortical insufficiency (Addison’s disease) and to
treat salt-losing adrenogenital syndrome
Mineralocorticoids: Therapeutic outcomes
•Control of blood pressure
•Restoration of fluid and electrolyte balance
Considerations
•Steroid therapy can mask symptoms of an infection
•Keep accurate I&O, daily weights, and vital signs
Mineralocorticoids •Evaluation of therapy
•Because fludrocortisone is a natural hormone, adverse
effects reflect fludrocotisone excess, such as sodium
accumulation and potassium depletion.
Drug Class: Glucocorticoids •Cortisone actions
•Diminishes secretion of cortisol from the adrenal cortex.
Glucocorticoids uses
•
Relieve the symptoms of tissue
inflammation
•
Immunosuppression
in the treatment of certain cancers,
organ transplantation, autoimmune diseases
•
Relief of
allergic
manifestations
•
Treatment of
shock
•
Nausea and vomiting
secondary to
chemotherapy
Glucocorticoids •Therapeutic outcomes
•Reduced pain and inflammation
•Minimized shock syndrome and faster recovery
•Reduced nausea and vomiting associated with
chemotherapy
Glucocorticoids Considerations
•Do not discontinue therapy abruptly.
•S/S of abrupt withdrawal:
•Fever, malaise, fatigue
•Weakness, anorexia, nausea
•Hypotension, fainting, dyspnea
•Hypoglycemia, muscle and joint pain
•Possible exacerbation of the disease process
Corticosteroids •Common and serious adverse effects
•Electrolyte imbalance – hypokalemia is most common
•Fluid accumulation
•Susceptibility to infection – often masks the symptoms of
infection.
•Behavioral changes – psychotic behaviors are more likely
to occur in patients with hx
Corticosteroids •Common and serious adverse effects
•Hyperglycemia – monitor blood glucose levels
•Peptic ulcer formation – monitor stool for blood
•Delayed wound healing – monitor for dehiscence
•Visual disturbances – may produce cataracts
•Osteoporosis
Corticosteroids: Drug Interactions
•Diuretics – may enhance the loss of K+
•Monitor for electrolyte imbalance
•Warfarin – may enhance or decrease the effects of
warfarin. Observe for S/S of bleeding. Monitor PT/INR.
•May require adjustment of warfarin
•Hyperglycemia – oral hypoglycemic agents and insulin
dosages may need to be adjusted.
Drug Class: Estrogens actions
Premarin (conjugated estrogen), Estrace (estradiol),
Vivelle, Estrasorb, Estrogel
ACTIONS
Maturation of the sex organs
Responsible for characteristics such as growth of hair,
texture of skin, distribution of body fat
Cause capillary dilation
Cause fluid retention and protein metabolism
Inhibit ovulation and postpartum breast engorgement
Estrogens USES
Relieving hot flash symptoms of menopause
Contraception
Hormone replacement therapy after oophorectomy
Treatment of osteoporosis
Treatment of severe acne in females
To slow the disease process in patients with certain
cancers
Estrogens: Therapeutic outcomes:
