Prednisone is a corticosteroid used to treat many different chronic diseases, including: inflammatory, allergic, hematologic, neoplastic, and autoimmune disorders. (Vallerand & Sanoski, 2011, p. 354) The major actions of prednisone are to suppress an sacute inflammatory process and for immunosuppression. (Kee, Hayes, & McCuistion, 2015, p. 753) Caution should be used in long-term treatment, as there are many side effects and adverse reactions, some of which are life-threatening, such as increased blood sugar, abnormal fat deposits in the face and trunk (also known as moon face and buffalo hump), decreased extremity size, muscle wasting, edema, sodium and water retention, hypertension euphoria or psychosis, thinned skin with purpura, glaucoma, peptic ulcers, and growth retardation. Using this drug for a long period of time can cause adrenal atrophy. (Kee, Hayes, & McCuistion, 2015, p. 753) When the drug is discontinued it is necessary for the dose to be tapered because abrupt withdrawal can result in severe adrenal cortical insufficiency. A patient may be taking prednisone for ulcerative colitis to control flare ups, which during severe flare ups may be the only medication that works, and experiences another flare up as soon as the treatment is finished. The patient could request to be put on the prednisone again to control their symptoms. However, because of the life-threatening adverse reactions that are possible from long-term use, it is extremely important the patient understands the risks. The nurse may give this medication in hopes to relieve the patients condition, however does not stress the seriousness of long-term use. Vallerand, A. H., & Sanoski, C. A. (2011). Daviss drug guide for nurses(14th ed.). Philadelphia, PA: F.A. Davis Company. Kee, Joyce, Hayes, E., McCuistion, L. (2015). Pharmacology: A patient-Centered Nursing Process Approach (8th ed.). St Louis, MO: Elsevier Saunders. STUDENT#2 .727272033691406px;= background-color:= rgb(247,= 247,= 247);=>Amitriptylline /tricyclics: Consider vulnerability issues with risk of suicidal overdose given anticholinergic effects Amitriptyline is an antidepressant. It potentiates the effect of serotonin and norepinephrine in the central nervous system. Has significant anticholinergic properties. Some adverse effects include the increased risk of suicide attempt/ideation especially during early treatment or dose adjustment; risk may be greater in children or adolescents. Additional adverse reactions include lethargy, sedation, blurred vision, dry eyes, dry mouth, arrhythmias, hypotension, and constipation. Scenerio: An adolescent, age 18, began taking amitriptylline to treat his symptoms of depression. He began having suicidal thoughts, but was scared to tell his physician in worries of taking him off the medication. He went to his checkups the first few weeks and told his physician he was feeling fine. His parents were aware of the adverse effects of increased suicide attempts in young adults and watched him carefully. Finally, his effects became so bad he told his physician at their next appointment.The physician was then able to lower his dosage accordingly and restrict the amount of drug available to him. This resolved the effects worsening and the possibility of the adolescent overdosing or commiting suicide by limiting the amount available for him to take while also being able to continue his medication. Desired outcomes: Increased sense of well-being, renewed interest in surroundings, increased appetite, improved energy level, improved sleep, and decrease in chronic pain symptoms. Reference: Deglin, J. H., & Vallerand, A. H. (2015). Daviss drug guide for nurses (14th ed). Philadelphia, Penn: F.A. Davis.