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Inhaled Steroids Nursing Pharmacology Study Guide - Nurseslabs
Inhaled Steroids Nursing Pharmacology Study Guide - Nurseslabs
Inhaled Steroids
UPDATED ON MAY 6, 2023 BY MARIANNE BELLEZA, R.N.
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Learn about inhaled steroids in this nursing pharmacology guide for student nurses! Get to know
its uses, side-effects, nursing considerations and more.
Inhaled steroids have been found to be a very effective treatment for bronchospasm. The drug of
choice depends on the individual patient’s response; a patient may have little response to one
agent and do very well on another.
Inhaled steroids:
beclomethasone (Beclovent)
budesonide (Pulmicort)
ciclesonide (Alvesco)
Fluticasone (Flovent)
triamcinolone (Azmacort)
Inhaling the steroid tends to decrease the numerous systemic effects that are associated
with steroid use.
It is usually useful to try another preparation if one is not effective within 2 to 3 weeks.
Therapeutic actions
The desired actions of inhaled steroids include:
Pharmacokinetics
These drugs are rapidly absorbed from the respiratory tract, but they from 2 to 3 weeks to reach
effective levels.
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T 1/2 2 to 3 hours
Metabolization Liver
Excretion Urine
Emergency use. Inhaled steroids are not for emergency use and are not for use during an
acute asthma attack or status asthmaticus.
Pregnancy or lactation. They should not be used during pregnancy or lactation unless the
benefit to the mother clearly outweighs any potential risk to the fetus or the nursing baby.
Active respiratory infection. These preparations should be used with caution in any
patient who has an active infection of the respiratory system because the depression of the
inflammatory response could result in serious illness
Adverse effects
Adverse effects of using inhaled steroids include the following:
Nursing Assessment
History taking and physical exam of a patient using inhaled steroids include:
Assess for possible contraindications and cautions: acute asthmatic attacks and allergy to
the drugs, which are contraindications; and systemic infections, pregnancy, or lactation,
which require cautious use.
Perform a physical examination to establish baseline data for assessing the effectiveness of
the drug and the occurrence of any adverse effects associated with drug therapy.
Assess temperature to monitor for possible infections.
Monitor blood pressure, pulse, and auscultation to evaluate cardiovascular response.
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Not for immediate relief. Do not administer inhaled steroids to treat an acute asthma
attack or status asthmaticus because these drugs are not intended for the treatment of
acute attack and will not provide the immediate relief needed.
Proper tapering of steroids. Taper systemic steroids carefully during the transfer to
inhaled steroids; deaths have occurred from adrenaline insufficiency with sudden
withdrawal.
Use decongestant drops. Have the patient use decongestant drops before using the
inhaled steroid to facilitate penetration of the drug if nasal congestion is a problem.
Oral care. Have the patient rinse the mouth after using the inhaler because this will help to
decrease systemic absorption and decrease GI upset and nausea.
Monitor for signs of infection. Monitor the patient for any sign of respiratory infection;
continued use of steroids during acute infection can lead to serious complications related
to the depression of the inflammatory and immune responses.
Educate the client. Provide patient teaching, including the drug name and prescribed
dosage, measures to help avoid adverse effects, warning signs that may indicate problems,
and the need for periodic monitoring and evaluation, to enhance patient knowledge about
drug therapy and to promote compliance.
Ensure the effectiveness of the drug. Instruct the patient to continue to take the drug to
reach and then maintain effective levels (drug takes 2 to 3 weeks to reach effective levels).
Provide support. Offer support and encouragement to help the patient cope with the
disease and the drug regimen.
Evaluation
Evaluation of a patient using inhaled steroids include:
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Evaluate the effectiveness of the teaching plan (patient can name drug, dosage, adverse
effects to watch for, specific measures to avoid them, and measures to take to increase the
effectiveness of the drug).
Monitor the effectiveness of other measures to ease breathing.
1. A Cromolyn sodium (Intal) inhaler is prescribed to a client with asthma. A nurse provides
instructions regarding the side effects of this medication. The nurse tells the client that
which undesirable effect is associated with this medication?
A. Insomnia
B. Constipation
C. Wheezing
D. Hypotension
1. Answer: C. Wheezing
Option C: Cromolyn Sodium (Intal) is used to prevent asthma attacks in people with
bronchial asthma. Undesirable side effects associated with the use of inhaler is wheezing,
cough, nasal congestion, bronchospasm, and throat irritation.
2. A nurse is about to administer Albuterol (Ventolin HFA) 2 puff and Budesonide (Pulmicort
Turbohaler) 2 puff by metered dose inhaler. The nurse plans to administer by?
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Option D: If two different inhaled medications are prescribed and one of the medications
contains a corticosteroid, administer the bronchodilator (Albuterol) first and the
corticosteroid (Budesonide) second. This will allow for the widening of the air passages by
the bronchodilator, making the corticosteroids more effective.
3. A nurse teaches a client about the use of a respiratory inhaler. Which action by the client
indicated a need for further teaching?
A. Removes the cap and shakes the inhaler well before use.
B. Presses the canister down with finger as he breathes in.
C. Inhales the mist and quickly exhales.
D. Waits 1 to 2 minutes between puffs if more than one puff has been prescribed.
Option C: The client should be instructed to hold his or her breath at least 10 to 15 seconds
before exhaling the mist.
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4. A client with acute asthma is prescribed short-term corticosteroid therapy. What is the
rationale for the use of steroids in clients with asthma?
5. The nurse is teaching the client how to use a metered dose inhaler (MDI) to administer a
Corticosteroid drug. Which of the following client actions indicates that he is using the MDI
correctly? Select all that apply.
5. Answer: A and D.
Recommended Resources
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See Also
Here are other nursing pharmacology study guides:
Antacids
Histamine-2 Antagonists
Proton Pump Inhibitors
Antihistamines
Bronchodilators and Antiasthmatics
Decongestants
Expectorants and Mucolytics
Inhaled Steroids
Lung Surfactants
Adrenocortical Agents
Antidiabetic Agents
Glucose-Elevating Agents
Hypothalamic Agents
Insulin
Parathyroid Agents: Bisphosphonates, Calcitonins
Pituitary Drugs
Sulfonylureas
Thyroid Agents
Antiarthritic Drugs
Immunostimulants
Immunosuppressants
Nonsteroidal Anti-Inflammatory Drugs
Salicylates
Chemotherapeutic Agents
Anthelmintics
Anti-Infective Drugs
Antibiotics
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Antifungals
Antineoplastic Agents
Antiprotozoal Drugs
Antiviral Drugs
Antidepressants
Antiparkinsonism Drugs
Antiseizure Drugs
Anxiolytics and Hypnotic Drugs
General and Local Anesthetics
Muscle Relaxants
Narcotics, Narcotic Agonists, and Antimigraine Agents
Neuromuscular Junction Blocking Agents
Psychotherapeutic Drugs
Antianginal Drugs
Antiarrhythmic Drugs
Antihyperlipidemic Drugs
Antihypertensive Drugs
Cardiotonic-Inotropic Drugs
Diuretics
Drugs Affecting Coagulation
Hinkle, J. L., & Cheever, K. H. (2018). Brunner and Suddarth’s textbook of medical-surgical
nursing. Wolters kluwer india Pvt Ltd.
Karch, A. M., & Karch. (2011). Focus on nursing pharmacology. Wolters Kluwer
Health/Lippincott Williams & Wilkins. [Link]
Kew, K. M., & Seniukovich, A. (2014). Inhaled steroids and risk of pneumonia for chronic
obstructive pulmonary disease. Cochrane Database of Systematic Reviews, (3).
Katzung, B. G. (2017). Basic and clinical pharmacology. McGraw-Hill Education.
Lehne, R. A., Moore, L. A., Crosby, L. J., & Hamilton, D. B. (2004). Pharmacology for nursing
care.
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Nursing Pharmacology
Drugs Affecting the Respiratory System
Nurses Outraged by Senator’s ‘Playing Cards’ Remark
Proton Pump Inhibitors
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