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DEN 2026 - Pharmacology > Corticosteroids > Flashcards

Corticosteroids Flashcards

1
Q

Name a disease which occurs when circulating levels of steroids is too high

A

Cushing’s disease

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2
Q

Name a disease which occurs when circulating levels of steroids is too low

A

Addison’s disease

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3
Q

Describe the HPA axis

A
  • Stress and circadian rhythm influences hypothalamus
  • CRH from hypothalamus signals pituitary
  • ACTH produced which signals adrenals to produce cortisol
  • Cortisol has tissue actions
  • Cortisol levels provide negative feedback at pituitary and hypothalamic levels
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4
Q

Name 2 main types of steroids

A
  1. Glucocorticoids

2. Mineralocorticoids

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5
Q

What is an example of a glucocorticoid?

A

Hydrocortisone

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6
Q

What is an example of a mineralocorticoid?

A

Aldosterone

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7
Q

Give an overview of the function of mineralocorticoids

A
  • Bind to mineralocorticoid receptor expressed in kidney and epithelial cells of colon and bladder
  • Regulate electrolyte balance
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8
Q

Describe 2 physiological outcomes caused by mineralocorticoids

A
  1. Increased sodium reabsorption in DCT

2. Increased potassium and hydrogen excretion

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9
Q

Where are steroid hormone receptors found in the cell?

A

Cytosol

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10
Q

How do activated glucocorticoid receptors identify target genes in the nucleus?

A

GC receptor dimers bind to specific hormone response elements (HREs) on target genes

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11
Q

Name 3 actions of glucocorticoids and drugs used for these purposes

A
  1. Metabolic (hydrocortisone)
  2. Anti-inflammatory (prednisolone)
  3. Immunosuppressive (dexamethasone)
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12
Q

What is the function of the metabolic effects of glucocorticoids?

A

Protecting glucose dependent tissues from starvation

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13
Q

Describe how metabolic effects of glucocorticoids affect the liver

A
  • Decrease glucose uptake
  • Decrease glucose utilization
  • Increase gluconeogenesis
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14
Q

Describe how metabolic effects of glucocorticoids affect muscle

A
  • Decreased protein synthesis

- Increase protein breakdown

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15
Q

Name 4 clinical uses of glucocorticoids

A
  1. Replacement therapy for Addison’s disease
  2. Anti-inflammatory
  3. Autoimmune disease
  4. Transplant patients
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16
Q

Describe how corticosteroids reduce inflammation

A
  • Suppress all phases of early inflammation
  • Decrease number of activated macrophages and T cells
  • Decreased IL-1 and IL-2 production
  • Decreased transcription of COX-2 and PLA2
17
Q

Describe Addison’s doosease

A

Primary hypoadrenalism

18
Q

What is the general rule for supplement steroid dose in dentistry for patients using long term steroids?

A
  • Generally do not supplement for routine dental procedures

- May need to supplement for general anaesthetic or implant insertion

19
Q

Name 5 therapeutic uses of steroids in dentistry

A
  1. Oral ulceration
  2. Post operative pain
  3. Pulp inflammation
  4. Pain from TMJ
  5. Bell’s Palsy
20
Q

Name 3 oral mucosal lesions which steroids may be used to treat

A
  1. Erosive lichen planus
  2. Erythema multiforme
  3. Pemphigus
21
Q

Name 3 types of steroidal therapies used for oral ulceration

A
  1. Topical
  2. Injection into lesion
  3. Systemic
22
Q

Name 2 types of oral surgery steroids will be used post operatively

A
  1. Post impacted 3rd molar removal

2. Post orthognathic surgery

23
Q

How are steroids administered for a patient with TMJ pain?

A

Intra-articular injecitons

24
Q

Name 4 major side effects of corticosteroid therapy

A
  1. Euphoria
  2. Cataracts
  3. Increased abdominal fat
  4. Poor wound healing
25
Q

How does Cushing’s syndrome arise?

A

Excess circulating glucocorticoids

26
Q

Name 2 treatments for Cushing’s disease

A
  1. Metyrapone

2. Ketoconazole

27
Q

What tends to cause excess glucocorticoids in Cushing’s disease?

A

Increasing circulating levels of GC or ACTH

28
Q

Where are thyroid hormone receptors found?

A

Cytosol of a cell

29
Q

What ion is required for the release of thyroid hormone?

A

Iodide

30
Q

How is iodide taken into the body?

A

Diet from fish, seaweed or dairy

31
Q

Name 4 functions of thyroid hormones

A
  1. Growth and development
  2. Calorigenic (heat generating)
  3. Metabolic (carbohydrate metabolism)
  4. Cardiovascular (increased HR)
32
Q

What is hypothyroidism?

A

Insufficient production of thyroid hormones

33
Q

What is the treatment for hypothyroidism?

A

Levothyroxine

34
Q

What are the symptoms of hypothyroidism in babies?

A

Severely shunted physical and mental growth

35
Q

What is hyperthyroidism?

A

Excess production of thyroid hormones causing Goitre

36
Q

Name 4 symptoms of hyperthyroidism

A
  1. Bulging eyeballs
  2. Muscle weakness
  3. Anxiety
  4. Increased HR
37
Q

Name 2 pharmacological treatments of hyperthyroidism

A
  1. Thyioureylenes

2. Potassium perchlorate

38
Q

How does potassium perchlorate function?

A

Inhibit iodine uptake in thyroid

39
Q

What is the major side effect of thyioureylenes?

A

Leucopenia

DEN 2026 - Pharmacology (22 decks)

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