Management of adrenocortical insufficiency (Addison’s Disease). Replace cortisol
in states of deficiency, suppress inflammation and normal immune response.
The adrenal glands sit on top of the kidneys.
The adrenal glands excrete steroid hormones, including cortisol that play a role in
increasing blood sugars, immune suppression, and metabolism of fat, protein, and
carbohydrates, as well as decreasing bone formation.
• Excreted by the liver – monitor liver profile
• Avoid in active untreated infections
• May cause CNS alterations
• May cause peptic ulcers
• May cause Cushingoid appearance (buffalo hump, moon face)
• Weight gain
• Decrease wound healing
• May elevate blood sugars
• May increase cholesterol and lipid values
Hey guys, let’s talk about cortisone, also known as Cortone. This is an oral, topical, and injectable medication, and here you can see it in its topical form as an over the counter medication. So remember when we talk about the therapeutic class versus the pharmacologic class, the therapeutic class is what the drug does in the body while the pharmacologic class is the chemical effect. So the therapeutic class of cortisone is an antiasthmatic and corticosteroid, while the pharmacologic class is also a corticosteroid. So what is the action of cortisone? So remember that the adrenal glands sit on top of the kidneys. The adrenal glands excrete steroid hormones, which include cortisol, which plays a role in increasing blood sugars, immune suppression, the metabolism of fat protein and carbohydrates, as well as decreasing bone formation. Cortisone is used for the management of Addison’s disease, which is an adrenocortical insufficiency, which replaces cortisol in states of deficiency, suppresses inflammation and the normal immune response. So some of the side effects that we see with cortisone are weight gain, elevated blood sugars, and that cushionoid appearance, which guys is that moon face or Buffalo hump.
So let’s take a look at a few nursing considerations for cortisone. Cortisone may cause CNS alterations, peptic ulcers, and decrease wound healing. Be sure to monitor the patient’s liver profile as cortisone is excreted by the liver. Cortisone needs to be avoided in patients who have an untreated infection. It’s important to mention that cortisone can increase cholesterol and lipid values. Teach the patient to report weight gain and non-healing wounds. So guys, when you hear cortisone, you should automatically think steroid and this should help you to remember the particulars of this drug. In the ICU, specifically, we give medications like this commonly to patients to decrease inflammation. That’s it for cortisone or Cortone. Now go out and be your best self today. And as always happy nursing.