- Body system
- Endocrine
- Name stem
- -sone, -olone
- Drug cards
- 1 in this guide
Drugs in this class
Other examples: Methylprednisolone, Hydrocortisone, Dexamethasone, Prednisolone, Budesonide.
How corticosteroids (glucocorticoids) work
Bind glucocorticoid receptors and suppress the genes that drive inflammation and the immune response.
Uses
- Asthma and COPD exacerbations
- Autoimmune and inflammatory diseases
- Allergic reactions
- Cerebral edema (dexamethasone)
- Adrenal insufficiency (hydrocortisone)
- Transplant rejection prevention
Adverse effects
- Hyperglycemia
- Infection risk and masked signs of infection
- Sodium and fluid retention, hypokalemia, hypertension
- Mood changes and insomnia
- Long-term: osteoporosis, cataracts, muscle wasting, thin skin, Cushing features, adrenal suppression
Nursing considerations
- Monitor glucose, potassium, blood pressure, weight and signs of infection.
- Taper after prolonged use to avoid acute adrenal insufficiency.
- Give oral doses with food, in the morning for once-daily dosing.
Patient teaching
- Do not stop suddenly.
- Avoid sick contacts and ask before live vaccines.
- Report black stools, signs of infection or rapid weight gain.
Corticosteroids (glucocorticoids) NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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A patient has taken prednisone for 3 months. Why must it be tapered rather than stopped?
Show answer
Answer D: To prevent acute adrenal insufficiency Long-term steroids suppress the adrenal glands. Stopping suddenly can cause adrenal crisis: hypotension, weakness, hypoglycemia and shock.
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Which lab value is most likely to rise in a patient on high-dose corticosteroids?
Show answer
Answer A: Blood glucose Glucocorticoids increase glucose production and insulin resistance. Potassium tends to fall.
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Why may a patient on long-term corticosteroids have an infection without a high fever?
Show answer
Answer B: Steroids suppress inflammation and mask signs of infection Steroids blunt the inflammatory response, so fever, redness and swelling may be minimal even in serious infection.
Frequently asked questions
What are corticosteroids (glucocorticoids)?
Corticosteroids are powerful anti-inflammatory and immunosuppressive drugs. Key nursing points: hyperglycemia, infection risk, fluid and potassium changes, and never stopping long-term therapy abruptly.
How do corticosteroids (glucocorticoids) work?
Bind glucocorticoid receptors and suppress the genes that drive inflammation and the immune response.
What are examples of corticosteroids (glucocorticoids)?
Prednisone, Methylprednisolone, Hydrocortisone, Dexamethasone, Prednisolone and Budesonide.
What are the nursing considerations for corticosteroids (glucocorticoids)?
Monitor glucose, potassium, blood pressure, weight and signs of infection. Taper after prolonged use to avoid acute adrenal insufficiency.