Pharmacology Question #41

Question

The nurse is instructing the patient with a new order for prednisone on the importance of medication adherence. Which statement by the patient indicates understanding of adverse reactions for non-adherence to medication management?

Answers

  1. “Cuts and other skin tears will heal more quickly.”
    • Rationale:

      This answer is not correct because cuts and other skin tears are more likely to occur due to the thinning of the skin associated with prednisone therapy. Prednisone also reduces the ability to heal and fight infection, so every effort should be made to prevent skin tears and assist in healing by keeping the wound clean.

  2. “I should not skip doses or run out prior to refill.”
    • Rationale:

      This answer is correct because prednisone should never be skipped or abruptly discontinued. This is extremely important for continuation of effective therapy and to prevent adrenal dysfunction. It is important for the patient to make sure to not run out of the medication by assuring prescriptions are ordered ahead of time so there is no chance of being without the medication, even for one dose. If the medication is being discontinued by the health care provider or the patient needs to stop taking the medication for some reason, the dosage should be gradually decreased to allow the adrenal glands to gradually resume their usual function and secretion of endogenous steroids.

  3. “Prednisone may cause my blood sugar to drop.”
    • Rationale:

      This answer is not correct because prednisone will increase blood glucose levels, not decrease the levels. This can occur in diabetics and non-diabetics, but is more severe in diabetics. Close blood glucose monitoring should occur during prednisone therapy.

  4. “I will avoid bananas and potassium containing foods.”
    • Rationale:

      This answer is not correct because there is a risk of hypokalemia during prednisone therapy. Intake of bananas and other high potassium foods should be encouraged to balance potassium levels.

Overview

Prednisone, a glucocorticoid, should never be skipped or stopped abruptly to prevent adverse reaction, such as adrenal dysfunction.

Explanation

Learning Outcomes

Prednisone is a glucocorticoid medication used to decrease inflammation in patients. It should never be skipped or abruptly discontinued. This is extremely important for continuation of effective therapy and to prevent adrenal dysfunction. It is important for the patient to make sure to not run out of the medication by assuring prescriptions are ordered ahead of time so there is no chance of being without the medication, even for one dose. If the medication is being discontinued by the health care provider or the patient needs to stop taking the medication for some reason, the dosage should be gradually decreased to allow the adrenal glands to gradually resume their usual function and secretion of endogenous steroids.

Test Taking Tip

Many medications should not be abruptly discontinued or skipped, but especially steroids, many medications that treat neurological conditions (seizures, Parkinson’s), and medications treating psychiatric conditions (depression, schizophrenia).

Video Rationale