HYDROCORTISONE

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(hye-droe-kor’ti-sone)
Aeroseb-HC, Alphaderm, Cetacort, Cortaid, Cort-Dome, Cortenema, Cortril, Dermacort, Dermolate, Hydrocortone, Hytone, Proctocort, Rectocort , Synacort
HYDROCORTISONE ACETATE
Anusol HC, CaldeCort, Carmol HC, Colifoam, Cortaid, Cortamed, Cort-Dome, Cortef Acetate, Corticaine, Cortifoam, Cortiment , Epifoam, Hydrocortone Acetate
HYDROCORTISONE CYPIONATE
Cortef Fluid
HYDROCORTISONE SODIUM PHOSPHATE
Hydrocortone Phosphate
HYDROCORTISONE SODIUM SUCCINATE
A-Hydrocort, Solu-Cortef
HYDROCORTISONE VALERATE
Westcort
Classifications: skin and mucous membrane agent; antiinflammatory; synthetic hormone; adrenal corticosteroids; glucocorticoid; mineralocorticoid
Pregnancy Category: C

NURSING IMPLICATIONS

Assessment & Drug Effects

• Establish baseline and continuing data on BP, weight, fluid and electrolyte balance, and blood glucose.
• Lab tests: Periodic serum electrolytes blood glucose, Hct and Hgb, platelet count, and WBC with differential.
• Monitor for adverse effects. Older adults and patients with low serum albumin are especially susceptible to adverse effects.
• Be alert to signs of hypocalcemia (see Appendix F).
• Ophthalmoscopic examinations are recommended every 2–3 mo, especially if patient is receiving ophthalmic steroid therapy.
• Monitor for persistent backache or chest pain; compression and spontaneous fractures of long bones and vertebrae present hazards.
• Monitor for and report changes in mood and behavior, emotional instability, or psychomotor activity, especially with long-term therapy.
• Be alert to possibility of masked infection and delayed healing (antiinflammatory and immunosuppressive actions).
• Note: Dose adjustment may be required if patient is subjected to severe stress (serious infection, surgery, or injury).
• Note: Single doses of corticosteroids or use for a short period (<1 wk) do not produce withdrawal symptoms when discontinued, even with moderately large doses.

Patient & Family Education

• Expect a slight weight gain with improved appetite. After dosage is stabilized, notify physician of a sudden slow but steady weight increase [2 kg (5 lb)/wk].
• Avoid alcohol and caffeine; may contribute to steroid-ulcer development in long-term therapy.
• Do not ignore dyspepsia with hyperacidity. Report symptoms to physician and do NOT self-medicate to find relief.
• Do NOT use aspirin or other OTC drugs unless prescribed specifically by the physician.
• Note: A high protein, calcium, and vitamin D diet is advisable to reduce risk of corticosteroid-induced osteoporosis.
• Notify physician of slow healing, any vague feeling of being sick, or return to pretreatment symptoms.
• Do not abruptly discontinue drug; doses are gradually reduced to prevent withdrawal symptoms.
• Report exacerbation of disease during drug withdrawal.
• Carry medical identification at all times. It needs to indicate medical diagnosis, drug therapy, and name of physician.
• Apply topical preparations sparingly in small children. The hazard of systemic toxicity is higher because of the greater ratio of skin surface area to body weight.
• Check shelf-life date on topical corticosterone during long-term use.
• Do not breast feed while taking/using this drug without consulting physician.

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• CORTICOSTEROIDS NURSING IMPLICATIONS Assessment & Drug Effects Establish baseline and continuing data on BP, weight, fluid and electrolyte balance, and blood glucose. Lab tests: Periodic serum electrolytes blood glucose, Hct and Hgb, platelet count, and WBC with differential. Monitor for
• PREDNISONE (pred’ni-sone) Apo-Prednisone , Deltasone, Meticorten, Orasone, Panasol, Prednicen-M, Sterapred, Winpred  Classifications: hormones and synthetic substitutes; adrenal corticosteroid; glucocorticoid Pregnancy Category: C   NURSING IMPLICATIONS Assessment & Drug Effects Establish baseline and continuing data regarding BP, I&O ratio and pattern, weight, and sleep pattern. Start flow chart as reference for planning individualized
• METOPROLOL TARTRATE (me-toe’proe-lole) Apo-Metoprolol, Betaloc , Lopressor, Norometoprol , Toprol XL Classifications: autonomic nervous system agent; beta-adrenergic antagonist (sympatholytic); antihypertensive Prototype: Propranolol Pregnancy Category: C NURSING IMPLICATIONS Assessment & Drug Effects Take apical pulse and BP before administering drug. Report to physician significant changes in rate, rhythm, or quality of pulse or variations in
• AMPICILLIN SODIUM AND SULBACTAM SODIUM (am-pi-sill’in/sul-bak’tam) Unasyn Classifications: antiinfective; antibiotic; aminopenicillin Prototype: Ampicillin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Determine previous hypersensitivity reactions to penicillins, cephalosporins, and other allergens prior to therapy. Lab tests: Baseline C&S tests prior to initiation of therapy; start drug pending results. Report promptly unexplained
• ETHINYL ESTRADIOL (eth’in-il ess-tra-dye’ole) Estinyl, Feminone Classifications: hormones and synthetic substitutes; estrogen Prototype: Estradiol Pregnancy Category: X NURSING IMPLICATIONS Assessment & Drug Effects Check BP on a regular basis in patients with conditions that may be influenced by fluid retention (migraine, cardiac or kidney dysfunction, asthma, epilepsy, hypertension). Supplement pyridoxine