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Flashcards in Cortico Steroids Deck (136)
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1
Q

Clinical Indications for Use of
Inhaled Corticosteroids

____ _ ____
COPD

A

Step 2 asthma

2
Q

Clinical Indications for Use of
Inhaled Corticosteroids

Step 2 asthma
_____

A

COPD

3
Q

Clinical Indications for Use of
Inhaled Corticosteroids

Intranasal aerosol agents:
Management of ? and perennial allergic and
nonallergic rhinitis

A

seasonal

4
Q

Clinical Indications for Use of
Inhaled Corticosteroids

Intranasal aerosol agents:
Management of seasonal and ? ? and
nonallergic rhinitis

A

perennial allergic

5
Q

Clinical Indications for Use of
Inhaled Corticosteroids

Intranasal aerosol agents:
Management of seasonal and perennial allergic and
____ ______?

A

nonallergic rhinitis

6
Q

Most common type of asthma

A

Allergic

7
Q

Allergic Asthma

Can be treated with ________
commonly known as allergy shots because
the exact triggering antigen is known.

A

immunotherapy

8
Q

Allergic Asthma

Can be treated with immunotherapy
commonly known as ____ ____ because
the exact triggering antigen is known.

A

allergy shots

9
Q

Allergic Asthma

Can be treated with immunotherapy
commonly known as allergy shots because
the exact triggering _____ is known.

A

antigen

10
Q

Allergic Asthma

Can be treated with immunotherapy
commonly known as allergy shots because
the exact triggering antigen is _____.

A

KNOWN

11
Q

Non-allergic asthma:
Triggered by:

_____ ___
Exercise
Stress
Infection

A

Cold air

12
Q

Non-allergic asthma:
Triggered by:

Cold air
______
Stress
Infection

A

Exercise

13
Q

Non-allergic asthma:
Triggered by:

Cold air
Exercise
_____
Infection

A

Stress

14
Q

Non-allergic asthma:
Triggered by:

Cold air
Exercise
Stress
______

A

Infection

15
Q

Non-allergic asthma:

No ____ ______ is identified.
No immune response is involved.

A

Specific Antigen

16
Q

Non-allergic asthma:

No specific antigen is identified.
No _______ response is involved.

A

Immune

17
Q

___-____ asthma:

No specific antigen is identified.
No immune response is involved.

A

Non-allergic

18
Q

Phases of the Inflam Response

A

Early Phase & Late Phase

19
Q

Phases of the Inflam Response

Early-phase response:
Local vasodilatation
_______ _______ ________
Redness

A

Increased vascular permeability

20
Q

Phases of the Inflam Response

Early-phase response:
_____ _______
Increased vascular permeability
Redness

A

Local vasodilation

21
Q

Phases of the Inflam Response

____-____response:
Local vasodilatation
Increased vascular permeability
Redness

A

Early-phase

22
Q

Phases of the Inflam Response

Early-phase response:
Local vasodilatation
Increased vascular permeability
_______

A

Redness

23
Q

Phases of the Inflam Response

Early-phase response:
Local vasodilatation
______ vascular permeability
Redness

A

Increased

24
Q

Phases of the Inflam Response
Early-phase response:

Furthermore, in ______ :
Bronchial contraction, wheezing, cough, dyspnea, and hypoxemia as a result of mast cell degranulation and histamine release.

Bronchodilators can reverse bronchospasm

A

asthma

25
Q

Phases of the Inflam Response
Early-phase response:

Furthermore, in asthma :
_____ _____, wheezing, cough, dyspnea, and hypoxemia as a result of mast cell degranulation and histamine release.

A

Bronchial contraction

26
Q

Phases of the Inflam Response
Early-phase response:

Furthermore, in asthma :
Bronchial contraction, _______, cough, dyspnea, and hypoxemia as a result of mast cell degranulation and histamine release.

A

wheezing

27
Q

Phases of the Inflam Response
Early-phase response:

Furthermore, in asthma :
Bronchial contraction, wheezing, _____, dyspnea, and hypoxemia as a result of mast cell degranulation and histamine release.

A

cough

28
Q

Phases of the Inflam Response
Early-phase response:

Furthermore, in asthma :
Bronchial contraction, wheezing, cough,______ and hypoxemia as a result of mast cell degranulation and histamine release.

A

dyspnea,

29
Q

Phases of the Inflam Response
Early-phase response:

Furthermore, in asthma :
Bronchial contraction, wheezing, cough, dyspnea, and ______ as a result of mast cell degranulation and histamine release.

A

hypoxemia

30
Q

Phases of the Inflam Response
Early-phase response:

Furthermore, in asthma :
Bronchial contraction, wheezing, cough, dyspnea, and hypoxemia as a result of ____ ____ ______ and histamine release.

A

mast cell degranulation

31
Q

Phases of the Inflam Response
Early-phase response:

Furthermore, in asthma :
Bronchial contraction, wheezing, cough, dyspnea, and hypoxemia as a result of mast cell degranulation and ______ _______

A

histamine release.

32
Q

Phases of the Inflam Response
_____-____ response:

Develops 6 to 8 hours later.
Much more difficult to resolve than early-phase
response.
Treatment is aimed at stopping inflammatory
progression before it occurs at this stage.
Hypersecretion of mucus.
Increased vascular permeability.

A

Late Phase

33
Q

Phases of the Inflam Response
Late-phase response:

Develops ___-___ ____ later.
Much more difficult to resolve than early-phase
response.

A

6 to 8 hours

34
Q

Whats more difficult to resolve

late phase or early phase?

A

Late Phase

35
Q

Phases of the Inflam Response
Late-phase response:

_______ of mucus.
Increased vascular permeability

A

Hypersecretion

36
Q

Phases of the Inflam Response
Late-phase response:

Treatment is aimed at stopping inflammatory
progression ____ it occurs at this stage.

A

Before

37
Q

Phases of the Inflam Response
Late-phase response:

Hypersecretion of mucus.
______ vascular permeability

A

Increased

38
Q

Phases of the Inflam Response
Late-phase response:

Hypersecretion of mucus.
Increased vascular_______

A

permeability

39
Q

Phases of the Inflam Response
Late-phase response:

Hypersecretion of mucus.
Increased ______ permeability

A

vascular

40
Q

Phases of the
Inflamm Response

_____ _____
Leukotrienes and prostaglandins are released.

A

Mucus plugging.

41
Q

Phases of the
Inflamm Response

Mucus plugging.
_______ and prostaglandins are released.

A

Leukotrienes

42
Q

Phases of the
Inflamm Response

Mucus plugging.
Leukotrienes and ______ are released.

A

prostaglandins

43
Q

Phases of the
Inflamm Response

Mucus plugging.
Leukotrienes and prostaglandins are_______

A

released.

44
Q

Treatment for allergic asthma.
Blocks the initial immune response and the
_______ process.

A

inflammatory

45
Q

Treatment for allergic asthma.
Blocks the initial ____ _____ and the
inflammatory process.

A

immune response

46
Q

______: Local dilation of blood

vessels, occurring in seconds

A

Redness

47
Q

Redness: Local dilation of blood

vessels, occurring in _____

A

seconds

48
Q

_____: Reddish color several
centimeters from the site, occurring
15 to 30 seconds after injury

A

Flare

49
Q

Flare: Reddish color several
centimeters from the site, occurring
___-____ seconds after injury

A

15 to 30

50
Q

____: Local swelling, occurring in

minutes

A

Wheal

51
Q

Wheal: _____ _____, occurring in

minutes

A

Local swelling

52
Q

Wheal: Local swelling, occurring in

_____

A

minutes

53
Q

______ vascular permeability:
An exudate is formed in the
surrounding tissues

A

increased

54
Q

Increased vascular permeability:
An exudate is formed in the
______ _______

A

surrounding tissues

55
Q

_______ infiltration: White cells
emigrate through capillary walls
(diapedesis) in response to
attractant chemicals (chemotaxis)

A

Leukocytic

56
Q

leukocytic infiltration: ____ ____
emigrate through capillary walls
(diapedesis) in response to
attractant chemicals (chemotaxis)

A

White cells

57
Q

leukocytic infiltration: White cells
emigrate through_____ _____
(diapedesis) in response to
attractant chemicals (chemotaxis)

A

capillary walls

58
Q

leukocytic infiltration: White cells
emigrate through capillary walls
(_______) in response to
attractant chemicals (chemotaxis)

A

diapedesis

59
Q

leukocytic infiltration: White cells
emigrate through capillary walls
(diapedesis) in response to
attractant chemicals (______)

A

chemotaxis

60
Q

______: White cells and
macrophages (in the lungs) ingest and
process foreign material such as bacteria

A

Phagocytosis

61
Q

Phagocytosis: _______ and
______ (in the lungs) ingest and
process foreign material such as bacteria

A

White cells; macrophages

62
Q

Phagocytosis: White cells and
macrophages (in the lungs)_____ and
process foreign material such as bacteria

A

ingest

63
Q

_____ _____: Histamine and
chemoattractant factors are released at the
site of injury, and various inflammatory
mediators such as complement and
arachidonic acid products are generated

A

Mediator cascade

64
Q

Mediator cascade: _______ and
chemoattractant factors are released at the
site of injury, and various inflammatory
mediators such as complement and
arachidonic acid products are generated

A

Histamine

65
Q
Mediator cascade: Histamine and 
\_\_\_\_\_\_\_ factors are released at the 
site of injury, and various inflammatory 
mediators such as complement and 
arachidonic acid products are generated
A

chemoattractant

66
Q

Mediator cascade: Histamine and
chemoattractant factors are released at the
site of injury, and various inflammatory
mediators such as _____ and
arachidonic acid products are generated

A

complement

67
Q

Mediator cascade: Histamine and
chemoattractant factors are released at the
site of injury, and various inflammatory
mediators such as complement and
_____ ______ products are generated

A

arachidonic acid

68
Q

Most common inflammation in the airway

A

Chronic Bronchitis

Asthma

69
Q
Treatment with antiinflammatory agents 
such as \_\_\_\_\_\_\_ is important to 
reduce the basal level of airway 
inflammation and thereby reduce airway 
hyperresponsiveness and the 
predisposition to acute episodes of 
obstruction
A

glucocorticoids

70
Q
Treatment with antiinflammatory agents 
such as glucocorticoids is important to 
reduce the \_\_\_\_\_ level of airway 
inflammation and thereby reduce airway 
hyperresponsiveness and the 
predisposition to acute episodes of 
obstruction
A

basal

71
Q
Treatment with antiinflammatory agents 
such as glucocorticoids is important to 
reduce the basal level of airway 
inflammation and thereby reduce airway 
\_\_\_\_\_\_\_\_ and the 
predisposition to acute episodes of 
obstruction
A

hyperresponsiveness

72
Q
Treatment with antiinflammatory agents 
such as glucocorticoids is important to 
reduce the basal level of airway 
inflammation and thereby reduce airway 
hyperresponsiveness and the 
\_\_\_\_\_\_\_ to acute episodes of 
obstruction
A

predisposition

73
Q
Treatment with antiinflammatory agents 
such as glucocorticoids is important to 
reduce the basal level of airway 
inflammation and thereby reduce airway 
hyperresponsiveness and the 
predisposition to \_\_\_\_\_ episodes of 
obstruction
A

acute

74
Q

Assess for presence of side effects of inhaled
steroid therapy

 Oral thrush
 Hoarseness
Voice changes
 cough/wheezing with MDI
 Use of reservoir with MDI
A

killl meeee

75
Q

Assess for presence of side effects of inhaled
______ therapy

 Oral thrush
 Hoarseness
Voice changes
 cough/wheezing with MDI
 Use of reservoir with MDI
A

steroid

76
Q

Assess for presence of side effects of inhaled
steroid therapy

\_\_\_\_\_ \_\_\_\_\_
 Hoarseness
Voice changes
 cough/wheezing with MDI
 Use of reservoir with MDI
A

Oral thrush

77
Q

Assess for presence of side effects of inhaled
steroid therapy

 Oral thrush
 Hoarseness
\_\_\_ \_\_\_\_\_\_\_
 cough/wheezing with MDI
 Use of reservoir with MDI
A

Voice changes

78
Q

Assess for presence of side effects of inhaled
steroid therapy

 Oral thrush
\_\_\_\_\_\_\_
Voice changes
 cough/wheezing with MDI
 Use of reservoir with MDI
A

Hoarseness

79
Q

Assess for presence of side effects of inhaled
steroid therapy

 Oral thrush
 Hoarseness
Voice changes
\_\_\_\_\_\_/\_\_\_\_ with MDI
 Use of reservoir with MDI
A

cough/wheezing

80
Q

Assess for presence of side effects of inhaled
steroid therapy

 Oral thrush
 Hoarseness
Voice changes
 cough/wheezing with MDI
 Use of \_\_\_\_\_\_ with MDI
A

reservoir

81
Q

_______ Side effects

 Renal insufficiency
 Extrapulmonary 
allergy
  Acute asthma
 HPA suppression (minimal)
 Growth retardation
 Osteoporosis
A

SYSTEMIC

82
Q

SYSTEMIC

\_\_\_\_\_ \_\_\_\_\_\_\_
 Extrapulmonary 
allergy
  Acute asthma
 HPA suppression (minimal)
 Growth retardation
 Osteoporosis
A

Renal insufficiency

83
Q

SYSTEMIC

 Renal insufficiency
 Extrapulmonary allergy
\_\_\_\_\_ asthma
 HPA suppression (minimal)
 Growth retardation
 Osteoporosis
A

Acute

84
Q

SYSTEMIC

 Renal insufficiency
\_\_\_\_\_\_ allergy
  Acute asthma
 HPA suppression (minimal)
 Growth retardation
 Osteoporosis
A

Extrapulmonary

85
Q

SYSTEMIC

 Renal insufficiency
 Extrapulmonary allergy
  Acute asthma
\_\_\_\_suppression (minimal)
 Growth retardation
 Osteoporosis
A

HPA

86
Q

SYSTEMIC

 Renal insufficiency
 Extrapulmonary allergy
  Acute asthma
 HPA \_\_\_\_\_\_\_\_ (minimal)
 Growth retardation
 Osteoporosis
A

suppression

87
Q

SYSTEMIC

 Renal insufficiency
 Extrapulmonary allergy
  Acute asthma
 HPA suppression (\_\_\_\_\_)
 Growth retardation
 Osteoporosis
A

minimal

88
Q

SYSTEMIC

 Renal insufficiency
 Extrapulmonary allergy
  Acute asthma
 HPA suppression  
 \_\_\_\_ \_\_\_\_\_\_\_\_
 Osteoporosis
A

Growth retardation

89
Q

SYSTEMIC

 Renal insufficiency
 Extrapulmonary allergy
  Acute asthma
 HPA suppression (\_\_\_\_\_)
 Growth retardation
\_\_\_\_\_\_\_\_\_
A

Osteoporosis

90
Q

______ Side Effects

Oropharyngeal fungal infections
Dysphonia
Cough, bronchoconstriction
Incorrect use of MDI

A

LOCAL

91
Q

LOCAL Side Effects

_______ fungal infections
Dysphonia
Cough, bronchoconstriction
Incorrect use of MDI

A

Oropharyngeal

92
Q

LOCAL Side Effects

Oropharyngeal fungal infections
________
Cough, bronchoconstriction
Incorrect use of MDI

A

Dysphonia

93
Q

LOCAL Side Effects

Oropharyngeal ______ infections
Dysphonia
Cough, bronchoconstriction
Incorrect use of MDI

A

fungal

94
Q

LOCAL Side Effects

Oropharyngeal fungal infections
Dysphonia
Cough, __________
Incorrect use of MDI

A

bronchoconstriction

95
Q

LOCAL Side Effects

Oropharyngeal fungal infections
Dysphonia
______, bronchoconstriction
Incorrect use of MDI

A

Cough

96
Q

LOCAL Side Effects

Oropharyngeal fungal infections
Dysphonia
Cough, bronchoconstriction
_____ use of MDI

A

Incorrect

97
Q

LOCAL Side Effects

Oropharyngeal fungal infections
Dysphonia
Cough, bronchoconstriction
Incorrect use of ____

A

MDI

98
Q

_____ suppression not seen in doses

< 800 ug

A

Adrenal

99
Q

Adrenal _______ not seen in doses

< 800 ug

A

suppression

100
Q

Adrenal suppression not seen in doses

< ____ __

A

800 ug

101
Q

Evidence of a beneficial, ___________
interaction between glucocorticoids and β-
adrenergic agonists

A

complementary

102
Q

Evidence of a beneficial, complementary
interaction between_______ and β-
adrenergic agonists

A

glucocorticoids

103
Q

Evidence of a beneficial, complementary

interaction between glucocorticoids and____-_____ ______

A

β-adrenergic agonists

104
Q

_____ increase β2-adrenergic receptor

transcription

A

Steroids

105
Q

Steroids_____ β2-adrenergic receptor

transcription

A

increase

106
Q

Steroids increase____-_____ receptor

transcription

A

β2-adrenergic

107
Q

steroids increase β2-adrenergic receptor

______

A

transcription

108
Q

______ corticosteroid therapy can provide
partial protection against development of
tolerance

A

Inhaled

109
Q

Inhaled corticosteroid therapy can provide
_____ _____ against development of
tolerance

A

partial protection

110
Q

Inhaled corticosteroid therapy can provide
partial protection against development of
_____

A

tolerance

111
Q

_______ has been shown to promote
binding of the glucocorticoid receptor to the
response element of the cell’s nuclear DNA

A

Salmeterol

112
Q

Salmeterol has been shown to promote
_____ of the glucocorticoid receptor to the
response element of the cell’s nuclear DNA

A

binding

113
Q

Salmeterol has been shown to promote
binding of the_______ receptor to the
response element of the cell’s nuclear DNA

A

glucocorticoid

114
Q

Salmeterol has been shown to promote
binding of the glucocorticoid receptor to the
response element of the cell’s ____ _____

A

nuclear DNA

115
Q

Salmeterol has been shown to promote
binding of the glucocorticoid receptor to the
______ element of the cell’s nuclear DNA

A

response

116
Q

______ corticosteroids
All of the steroids available as orally
inhaled agents are also available in an
intranasal formulation

A

Intranasal

117
Q

Intranasal corticosteroids
All of the steroids available as____ ____
agents are also available in an
intranasal formulation

A

orally

inhaled

118
Q
Used for treatment of allergic or 
inflammatory nasal conditions and 
seasonal or perennial allergic or 
nonallergic rhinitis and to prevent 
reoccurrence of nasal polyps
A

Intranasal corticosteroids

119
Q

Systemic administration of ______

 Suppression of the HPA axis 
  immunosuppression 
 Psychiatric reactions 
 Cataract formation
  Myopathy of striated skeletal muscle 
 Peptic ulcer
A

steroids

120
Q

Systemic administration of steroids

 Suppression of the\_\_\_ \_\_\_ 
  immunosuppression 
 Psychiatric reactions 
 Cataract formation
  Myopathy of striated skeletal muscle 
 Peptic ulcer
A

HPA axis

121
Q

Systemic administration of steroids

 Suppression of the HPA axis 
 \_\_\_\_\_\_\_\_\_
 Psychiatric reactions 
 Cataract formation
  Myopathy of striated skeletal muscle 
 Peptic ulcer
A

immunosuppression

122
Q

Systemic administration of steroids

 Suppression of the HPA axis 
  immunosuppression 
 \_\_\_\_\_\_ reactions 
 Cataract formation
  Myopathy of striated skeletal muscle 
 Peptic ulcer
A

Psychiatric

123
Q

Systemic administration of steroids

 Suppression of the HPA axis 
  immunosuppression 
 Psychiatric reactions 
 Cataract formation
  Myopathy of striated skeletal muscle 
 \_\_\_\_ \_\_\_\_
A

Peptic ulcer

124
Q

Systemic side effects with _____
administration

Of major concern:
HPA suppression
Loss of bone density
Growth restriction in children

A

aerosol

125
Q

Systemic side effects with aerosol
administration

Of major concern:
____ ______
Loss of bone density
Growth restriction in children

A

HPA suppression

126
Q

Systemic side effects with aerosol
administration

Of major concern:
HPA suppression
_____ ___ ____ ____
Growth restriction in children

A

Loss of bone density

127
Q

Systemic side effects with aerosol
administration

Of major concern:
HPA suppression
Loss of bone density
_____ _____ _____ _____

A

Growth restriction in children

128
Q

Clinical Application of Aerosol
_____

Use in asthma
Early use in asthma
For acute severe asthma
Clinical use of inhaled corticosteroids

A

Steroids

129
Q
Clinical Application of Aerosol 
Steroids
Use in\_\_\_\_\_
Early use in asthma
For acute severe asthma
Clinical use of inhaled corticosteroids
A

asthma

130
Q
Clinical Application of Aerosol 
Steroids
Use in asthma
Early use in asthma
For acute severe asthma
Clinical use of inhaled \_\_\_\_\_\_
A

corticosteroids

131
Q

Clinical Application of Aerosol
Steroids

Use in _____
Relieves symptoms
Little or no effect on FEV1

A

COPD

132
Q

Clinical Application of Aerosol
Steroids

Use in copd
Relieves symptoms
Little or no effect on _____

A

FEV!

133
Q

Inahled corticosteroid

Controller or Rescue

A

Controller

134
Q

Steroid Dependency

Classified into two forms:

A

Physiologic - Psychological

135
Q

___________—Desire occurs because of an
induced sense of well-being or effective
symptom relief when taking the drug.

A

Psychological

136
Q

________ —Steroid suppression of the
normal functions of the HPA occurs when
a patient is withdrawn from steroids too
quickly.

A

Physiologic