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.
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.
Global Rationale: Alternate day administration can limit adrenal atrophy. 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. Topical application does not cause as many systemic effects as oral dosage. Corticosteroid doses are generally started high and worked down to discontinuance. Using a less systemic approach would lessen effects.
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