Glucocorticoid Drugs

Question 1

Glucocorticoids/corticosteroids effect at low volumes

Answer 1

Physiologic effects, carbohydrate metabolism raises blood glucose levels, unfavorable effect on protein metabolism (neg nitrogen balance), stimulation of fat breakdown and also fat redistribution (cushings), often done to treat endocrine disorders

Question 2

Glucocorticoids/corticosteroids effect at high volumes

Answer 2

Suppress inflammation, certain cancers, and immune system at higher doses

Question 3

Glucocorticoids/corticosteroids toxicity

Answer 3

Non toxic at physiologic doses or acute high dosage, but if high dose chronically can see severe toxicity

Question 4

2 examples of Glucocorticoids/corticosteroids

Answer 4

prednisone, cortisone

Question 5

Stress effects of Glucocorticoids/corticosteroids

Answer 5

Surge in glucocorticoids in response to stress, absence in sufficient amounts results in hypotension, hypoglycemia, and circulatory failure

Question 6

Water and electrolyte effects of Glucocorticoids/corticosteroids

Answer 6

Glucocorticoids to varying degrees act like aldosterone to act on kidney promoting retention of sodium and water resulting in hypernatremia, edema, and hypokalemia

Question 7

Respiratory effects of Glucocorticoids/corticosteroids

Answer 7

In a pre term infant, low corticosteroid production results in increased incidence of respiratory distress syndrome because it is required during delivery to stimulate lung maturation

Question 8

Glucocorticoids/corticosteroids release mech

Answer 8

• stress acts on hypothalamus
• hypothalamus releases CRF
• Ant pit receives CRF and releases ACTH
• The adrenal cortex receives ACTH and causes release of glucocorticoids that has neg feedback on hypothalamus and ant pituitary

Question 9

Glucocorticoids/corticosteroids mech of action at cellular levels

Answer 9

• Bind to intracellular receptors blocking RNA synthesis

- Directly modulate protein production by allowing RNA synthesis

Question 10

Anti inflammatory effects of Glucocorticoids/corticosteroids

Answer 10

Prevent the symptoms of inflammation, warmth redness and swelling and tenderness

Question 11

NSAIDS act on ___ enzyme to prevent ___ formation

Answer 11

cyclooxygenase, prostacyclins

Question 12

Glucocorticoids/corticosteroids act on ___ enzyme to prevent ___ formation, and are thus ___ than NSAIDS

Answer 12

arachodonic acid formation (delta 6 desaturator), leukotrienes and prostacyclins downstream, stronger

Question 13

Glucocorticoids/corticosteroids immunosuppresive function (2)

Answer 13

• IL1 activation

- chemotaxis inhibition

Question 14

High dose Glucocorticoids/corticosteroids treat ___

Answer 14

non endocrine disorders

Question 15

RA treatment by Glucocorticoids/corticosteroids

Answer 15

Reduces inflammation and pain, but does not alter course of disease, prolonged systemic use should be avoided

Question 16

Systemic lupus erythematosus treatment by Glucocorticoids/corticosteroids

Answer 16

Severe episodes can be managed with aggressive administration

Question 17

IBS and crohn’s treatment by Glucocorticoids/corticosteroids

Answer 17

Administration via oral or enema may help bring relief

Question 18

DOC for life threatening allergic reactions is…

Why isn’t it glucocorticoids?

Answer 18

Epi, because the response is delayed they cannot serve acute allergic rxns

Question 19

Most effective treatment for asthma and what is the best way to administer it?

Answer 19

Glucocorticoids/corticosteroids, Inhalation

Question 20

Dermatologic disorders treated by Glucocorticoids/corticosteroids (4)

Answer 20

• Psoriasis
• mycoses
• seborrhea
• contact dermatitis

Question 21

Glucocorticoids ADR’s (8)

Answer 21

• Usually not seen in physiologic or brief treatment
• Adrenal insufficiency due to suppression of cortex and potential atrophy
• Risk of new infection or reactivation of latent infection via immune suppression
• Decreased production of cytoprotective prostaglandins that produce mucus and inhibit acid production in the stomach resulting in peptic ulcer
• prolonged use increased risk of osteoperosis
• Mental disorders
• cataracts and glaucoma
• Delayed growth in children
• Nose dryness

Question 22

Glucocorticoids/corticosteroids effect on pregnancy and lactation

Answer 22

• prolonged high dose therapy can cause fetal adrenal hyperplasia
• Breast feeding risk of transfer to infant

Question 23

Glucocorticoids/corticosteroids drug interactions

Answer 23

• Insulin and oral hypoglycemics make glucocorticoids require a higher dosage
• vaccines should not be given, especially live ones
• NSAIDS increase risk of peptic ulceration

Question 24

Cardiovascular effects of Glucocorticoids/corticosteroids

Answer 24

Required to maintain functional integrity of vascular system, low levels cause increased capillary permeability and vasodilation, increase in RBC count and decrease in WBC count

Question 25

List a common glucocorticoid inhaler used as effective treatment of asthma

Answer 25

Pulmicort (budesonide)

Question 26

Neoplasms of ___ origin can be effeectively treated in conjunction with other anticancer agents by ___

Answer 26

lymphatic tissue, glucocorticoids