McKenna's Pharmacology for Nursing, 2e

36

Adrenocortical agents

Learning objectives Upon completion of this chapter, you should be able to:

1. Explain the control of the synthesis and secretion, and physiological effects of the adrenocortical agents. 2. Describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse reactions and important drug–drug interactions associated with the adrenocortical agents. 3. Discuss the use of adrenocortical agents across the lifespan. 4. Compare and contrast the prototype drugs prednisone and fludrocortisone with other adrenocortical agents. 5. Outline the care considerations, including important teaching points, for people receiving an adrenocortical agent.

Test your current knowledge of adrenocortical agents with a PrepU Practice Quiz!

Glossary of key terms adrenal cortex: outer layer of the adrenal gland; produces glucocorticoids and mineralocorticoids in response to adrenocorticotropic hormone (ACTH) stimulation; also responds to sympathetic stimulation adrenal medulla: inner layer of the adrenal gland; a sympathetic ganglion, it releases noradrenaline and adrenaline into circulation in response to sympathetic stimulation corticosteroids: steroid hormones produced by the adrenal cortex; include androgens, glucocorticoids and mineralocorticoids diurnal rhythm: response of the hypothalamus and then the pituitary and adrenals to wakefulness and sleeping; normally, the hypothalamus begins secretion of corticotropin-releasing factor (CRF) in the evening, peaking at about midnight; adrenocortical peak response is between 6 and 9 a.m.; levels fall during the day until evening, when the low level is picked up by the hypothalamus and CRF secretion begins again glucocorticoids: steroid hormones released from the adrenal cortex; they increase blood glucose levels, fat deposits and protein breakdown for energy mineralocorticoids: steroid hormones released by the adrenal cortex; they cause sodium and water retention and potassium excretion

ADRENOCORTICAL AGENTS Glucocorticoids

Mineralocorticoids cortisone fludrocortisone hydrocortisone

budesonide cortisone

methylprednisolone prednisolone prednisone triamcinolone

beclomethasone betamethasone

dexamethasone hydrocortisone