A Cushion of steroids
Everything is high except potassium
Hyperglycemia
High Sugar
Hypernatremia
High Sodium
Cushing Disease
Cushing's Syndrome
- Cushing’s syndrome is too much adrenal hormone due to steroid therapy or an adrenal tumor that secretes cortisol. There is also high aldosterone (↑ sodium, ↓ potassium).
- Cushing’s disease is a rare condition thatis specific to a pituitary adenoma. The adenoma secretes too much ACTH leading to ↑ cortisol.
- Everything is high EXCEPT potassium
- Hypernatremia, hypertension, hyperglycemia and high weight
- Too much cortisol/steroids leads to osteoporosis, weak immune system, infection, and poor wound healing
- Hypokalemia is the only hypo
Hypertension
High Blood Pressure
Weight gain
High Weight
High Hormone
High Cortisol
Causes
Cushing’s syndrome is too much adrenal hormone due to steroid therapy or an adrenal tumor that secretes cortisol. Cushing’s Disease is a rare condition specific to a pituitary adenoma
Other Symptoms
Muscle wasting, volume overload, Buffalo hump, truncal obesity, supraclavicular fat pads, striae (stretch marks), Hairy (Hirsutism), weak immune system, osteoporosis, & poor wound healing.
Treatment
Treat the cause, of course. If it is an adrenal gland problem, the client may need an adrenalectomy with life-long steroid replacement.
The Syndrome Versus the Disease
- Cushing syndrome is a disorder with physical and mental changes that result from having too much cortisol in the blood for a long period of time. There are two types of Cushing syndrome: exogenous (outside the body=steroid therapy with medications such as prednisolone, betamethasone, dexamethasone, hydrocortisone) and endogenous (too much cortisol production such as in an adrenal gland problem). Cushing Syndrome is the umbrella term that contains Cushing Disease.Â
- Cushing Disease is a rare condition that is more common in women. A pituitary adenoma is the most common cause of Cushing Disease. Â
- Pay attention: Most of the time when we are talking about Cushing, we are talking about the syndrome because the disease is rare.
Steroids
Decrease immune function (High risk for INFECTION) and decrease calcium absorption and increase breakdown (OSTEOPOROSIS)
Steroid Alert
Never stop steroids abruptly. TAPER. Let me say it again, TAPER. Abruptly stopping steroids may cause ADDISONIAN CRISIS. When you give too much steroids (or for a long time), the adrenal glands start thinking "I don't have to do anything anymore. I will stop working since there are "exogenous steroids" available. So reduce dosage or taper to give time for adrenal glands to wake up and do their job.
This is an Alert
Long-term use of steroids causes Cushing Syndrome. After a while, you start seeing the acne, the moon face, the truncal obesity, osteoporosis, high risk for infection and so on and on. NCLEX loves it when you know that steroids can cause: gastric ulcers, cataracts, and osteoporosis so watch for gastric discomfort, bad vision, and joint pain! Say it again: watch for gastric discomfort, bad vision and joint pain when on steroids.