A client will be prescribed an oral corticosteroid for treatment of a rash. The prescriber says, "In order to avoid adverse effects, I am prescribing the smallest amount possible."
What other prescribing regimens could the nurse suggest to achieve this same effect?
1. Give the oral medication every other day.
2. Administer a larger dose for a few days and then gradually decrease the dose until the medication is discontinued.
3. Use a topical application instead of an oral product.
4. Start with a small dose and work up to the desired dose.
5. Administer the doses intramuscularly for the first few days of treatment.
Correct Answer: 1,2,3
Rationale 1: Alternate day administration can limit adrenal atrophy.
Rationale 2: There are specific formulations of corticosteroids that are packaged for use of a large dose initially which is then tapered off until all the medication is gone.
Rationale 3: Topical application does not cause as many systemic effects as oral dosage.
Rationale 4: Corticosteroid doses are generally started high and worked down to discontinuance.
Rationale 5: Using a less systemic approach would lessen effects.
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