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PHA2 > Adrenal Cortex > Flashcards

Adrenal Cortex Flashcards

1
Q

How potent are prednisolone and dexamethosone compared to Cortisol/Hydrocortisone?

A 
Prednisolone = 4x more potent
Dexamethasone = 30x more potent (7.5x more potent than pred)
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2
Q

Which steroid requires hepatic activation?

A

Prednisone needs to be turned into prednisolone at the liver

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3
Q

What are the short acting steroids? (

A

Hydrocortisone, Prednisone, Methylprednisone

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4
Q

What the Intermediate acting steroid? (24-48h)

A

Triamcinolone

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5
Q

What are the long acting steroids? (>48h)

A

Betamethasone, dexamethasone

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6
Q

What are the two salt esters?

A

Sodium phosphate and sodium succinate

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7
Q

How do salt esters effect the steroids?

A

Allow steroids to become soluble for IV injection.

Gives the drugs a faster onset but the same duration as their oral/base steroid.

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8
Q

What are the insoluble esters?

A

Acetate and Acetonide

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9
Q

What do insoluble esters do to the steroids?

A

delays the onset of action and duration to allow for a longer absorption.

duration will be much longer than the oral/base steroid.

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10
Q

What steroid cannot become an ophthalmic or dermatologic drug?

A

Prednisone bc it needs to be change in the liver

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11
Q

What is fluticasone used for?

A

inhaled glucocorticoid for pulmonary disease

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12
Q

What is Budesonide used for?

A

To treat GI disease, works locally at GIT then has high first pass metabolism

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13
Q

How are steroids metabolized and excreted?

A

Widely distributed even to the CNS
highly bound to PP
metabolized to release base steroid
excreted in the urine

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14
Q

What drug should NEVER be used with glucocorticoids???

A

NSAIDS!!!!

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15
Q

Side effects of glucocorticoids?

A

Short term: PU/PD, stress leukogram, decreased T3 measurement
Long term: immune suppression, poor wound healing, hypertension, RISK OF ADDISONS

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16
Q

What is the replacement dosing for glucocorticoids?

A

Pred 0.1-0.22mg/kg/day

17
Q

What is the anti-inflammatory dosing for glucocorticoids?

A

Pred 0.5-1mg/kg/day

18
Q

What is the Immunosuppressive dosing for glucocorticoids?

A

Pred 2-4mg/kg/day

19
Q

What is the predominate effect of mineralcorticoids?

A

essentially aldosterone so Na+ retention.

20
Q

What are the two mineralcorticoids that we know?

A

Desoxycorticosterone Pivalate (DOCP) and Fludrocortisone

21
Q

How do you give DOCP?

A

Given IM, no glucocorticoid effects, monitor Na+ and K+ levels

22
Q

How do you give fludrocortisone?

A

Orally, more potent and has glucocorticoid effect, monitor Na+ and K+ levels

23
Q

T/F Dexamethasone has less mineralcorticoid effect than prednisolone

A

True.

So when treating with a steroid in a cardiac dysfunction p, you may want to consider using dex over pred

24
Q

What drug is the index corticosteroid with meralcorticoid and glucocorticoid activity of ‘1’?

A

Cortisol/Hydrocortisone

PHA2 (9 decks)

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