ACTIVE LEARNING TEMPLATE: Medication Bruno Dossantos STUDENT NAME______________________________________ Prednisone MEDICATION___________________________________________________________________________ REVIEW MODULE CHAPTER____________ Intermediate-acting glucocorticoid CATEGORY CLASS__Corticosteroid, _____________________________________________________________________ PURPOSE OF MEDICATION Expected Pharmacological Action Decreases inflammation by increasing capillary permeability and lysosomal stabilization, minimal mineralocorticoid activity Therapeutic Use Severe inflammation, neoplasms, multiple sclerosis, collagen disorders, dermatologic disorders, pulmonary fibrosis, asthma Complications CNS: Depression, flushing, sweating, headache, mood changes CV: Hypertension, thrombophlebitis, embolism, tachycardia, fluid retention EENT: Fungal infections, increased intraocular pressure, blurred vision GI: Diarrhea, nausea, abdominal distention, GI hemorrhage, increased appetite, pancreatitis INTEG: Acne, poor wound healing, ecchymosis, petechiae META: Hyperglycemia MS: Fractures, osteoporosis, weakness MISC: Decreased immune response Medication Administration ＂ Adult: PO 5-60 mg/day or divided bid-qid ＂ Child: PO 0.05-2 mg/kg/day divided 1-4×/day Contraindications/Precautions Fungal infections, hypersensitivity, Pregnancy, diabetes mellitus, glaucoma, osteoporosis, seizure disorders, ulcerative colitis, HF, myasthenia gravis, renal disease, esophagitis, peptic ulcer, cataracts, coagulopathy, abrupt discontinuation, children, corticosteroid hypersensitivity, Cushing syndrome, diabetes mellitus, ulcerative colitis, thromboembolism, geriatric patients, acute MI Interactions Increase: tendon rupture—quinolones Increase: side effects—alcohol, salicylates, NSAIDs, amphotericin B, digoxin, cycloSPORINE, diuretics Increase: predniSONE action—salicylates, estrogens, NSAIDs, oral contraceptives, ketoconazole, macrolide antiinfectives Increase: predniSONE effect—CYP3A4 inhibitors Decrease: predniSONE effect—CYP3A4 inducers Nursing Interventions Assess: ＂ Adrenal insufficiency: nausea, vomiting, anorexia, confusion, hypotension, weight loss before or during treatment; HPA suppression may be precipitated by abrupt withdrawal ＂ Potassium, blood glucose, urine glucose while patient receiving long-term therapy; hypokalemia and hyperglycemia; plasma cortisol with long-term therapy, normal: 138-635 nmol/L SI units drawn at 8 am Client Education Evaluation of Medication Effectiveness Therapeutic response: ease of respirations, decreased inflammation ACTIVE LEARNING TEMPLATES That emergency ID as corticosteroid user should be carried; provide information about product being taken and condition ＂ To notify prescriber if therapeutic response decreases; that dosage adjustment may be needed ＂ To avoid vaccinations ＂ Not to discontinue abruptly; adrenal crisis can result Therapeutic Procedure A7
