Prednisone Drug Study

Friday, February 20, 2009

In making a Drug Study, the following elements must be present: Generic Name and the Brand name (not all brands, just the brand used by the patient), Action, Indication, Pregnancy Category, Drug Classification, and Contraindication, Adverse Effect, Drug interaction and Nursing Consideration/Intervention…. Most clinical instructors preferred this to be in a long bond paper in printed or handwritten with paper in landscape.

Prednisone


Brand Name: Apo-Prednisone (CAN), Deltasone, Liquid Pred, Meticorten, Novo-Prednisone (CAN), Orasone, Panasol-S, Prednicen-M, Prednisone-Intensol, Sterapred DS, Winpred (CAN)


Pregnancy Category C


Drug classes: Corticosteroid (intermediate acting), Glucocorticoid, Hormone


Therapeutic actions

Enters target cells and binds to intracellular corticosteroid receptors, thereby initiating many complex reactions that are responsible for its anti-inflammatory and immunosuppressive effects.


Indications

· Replacement therapy in adrenal cortical insufficiency

· Hypercalcemia associated with cancer

· Short-term management of various inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases (eg, SLE), dermatologic diseases

(eg, pemphigus), status asthmaticus, and autoimmune disorders

· Hematologic disorders: thrombocytopenia purpura, erythroblastopenia

· Ulcerative colitis, acute exacerbations of multiple sclerosis and palliation in some leukemias and lymphomas

· Trichinosis with neurologic or myocardial involvement


Contraindications

· Contraindicated with infections, especially tuberculosis, fungal infections, amebiasis, vaccinia and varicella, and antibiotic-resistant infections; lactation.


Adverse effects

Vertigo, headache, paresthesias, insomnia, convulsions, psychosis, cataracts, increased intraocular pressure, glaucoma (long-term therapy)

Hypotension, shock, hypertension and CHF secondary to fluid retention, thromboembolism, thrombophlebitis, fat embolism, cardiac arrhythmias

Na+ and fluid retention, hypokalemia, hypocalcemia

Amenorrhea, irregular menses, growth retardation, decreased carbohydrate tolerance, diabetes mellitus, cushingoid state (long-term effect), increased blood sugar, increased serum cholesterol, decreased T3 and T4 levels, HPA suppression with systemic therapy longer than 5 days

Peptic or esophageal ulcer, pancreatitis, abdominal distention, nausea, vomiting, increased appetite, weight gain (long-term therapy)

Hypersensitivity or anaphylactoid reactions

· Increased therapeutic and toxic effects with troleandomycin, ketoconazole

· Increased therapeutic and toxic effects of estrogens, including hormonal contraceptives

· Risk of severe deterioration of muscle strength in myasthenia gravis patients who also are receiving ambenonium, edrophonium, neostigmine, pyridostigmine

· Decreased steroid blood levels with barbiturates, phenytoin, rifampin

· Decreased effectiveness of salicylates


Nursing considerations

· Administer once-a-day doses before 9 AM to mimic normal peak corticosteroid blood levels.

· Increase dosage when patient is subject to stress.

· Taper doses when discontinuing high-dose or long-term therapy.

· Do not give live virus vaccines with immunosuppressive doses of corticosteroids.


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