Corticosteroids
Synthetic glucocorticoids used for inflammation, immunosuppression, and endocrine replacement
Definition
Corticosteroids (glucocorticoids) are synthetic analogs of cortisol used for their anti-inflammatory, immunosuppressive, and hormone-replacement effects. Common indications include asthma, COPD, autoimmune disease, allergic reactions, organ transplant, and adrenal insufficiency.
Common Drugs
- Prednisone (oral)
- Prednisolone
- Methylprednisolone (Solu-Medrol - IV)
- Hydrocortisone (oral, IV, topical)
- Dexamethasone
- Budesonide (inhaled)
- Fluticasone (inhaled, nasal)
- Triamcinolone (topical, intra-articular)
Side Effects (Many)
- Short-term: Hyperglycemia, mood changes, insomnia, increased appetite, fluid retention, leukocytosis.
- Long-term (Cushingoid): Weight gain, moon face, buffalo hump, central obesity, striae, thin skin, easy bruising, osteoporosis, cataracts, glaucoma, immunosuppression, adrenal suppression.
Critical Nursing Considerations
- Never stop abruptly: Risk of adrenal crisis. Taper gradually.
- Stress dose: Patients on long-term steroids need increased doses during surgery, infection, trauma.
- Take with food: Reduce GI upset. Consider PPI for prolonged therapy.
- Monitor glucose: Diabetics may need insulin adjustment.
- Infection risk: Report fever, wounds that do not heal.
- Osteoporosis prevention: Calcium, vitamin D, weight-bearing exercise.
- Inhaled steroids: Rinse mouth after use to prevent thrush.
NCLEX Relevance
Taper, stress dose, and Cushingoid side effects are classic test topics.