Cortico Steroids Flashcards by David Purk

Clinical Indications for Use of
Inhaled Corticosteroids

____ _ ____
COPD

Step 2 asthma

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Clinical Indications for Use of
Inhaled Corticosteroids

Step 2 asthma
_____

COPD

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Clinical Indications for Use of
Inhaled Corticosteroids

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

seasonal

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Clinical Indications for Use of
Inhaled Corticosteroids

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

perennial allergic

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Clinical Indications for Use of
Inhaled Corticosteroids

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

nonallergic rhinitis

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Most common type of asthma

Allergic

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Allergic Asthma

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

immunotherapy

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Allergic Asthma

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

allergy shots

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Allergic Asthma

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

antigen

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Allergic Asthma

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

KNOWN

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Non-allergic asthma:
Triggered by:

_____ ___
Exercise
Stress
Infection

Cold air

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Non-allergic asthma:
Triggered by:

Cold air
______
Stress
Infection

Exercise

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Non-allergic asthma:
Triggered by:

Cold air
Exercise
_____
Infection

Stress

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Non-allergic asthma:
Triggered by:

Cold air
Exercise
Stress
______

Infection

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Non-allergic asthma:

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

Specific Antigen

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Non-allergic asthma:

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

Immune

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___-____ asthma:

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

Non-allergic

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Phases of the Inflam Response

Early Phase & Late Phase

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Phases of the Inflam Response

Early-phase response:
Local vasodilatation
_______ _______ ________
Redness

Increased vascular permeability

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Phases of the Inflam Response

Early-phase response:
_____ _______
Increased vascular permeability
Redness

Local vasodilation

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Phases of the Inflam Response

____-____response:
Local vasodilatation
Increased vascular permeability
Redness

Early-phase

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Phases of the Inflam Response

Early-phase response:
Local vasodilatation
Increased vascular permeability
_______

Redness

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Phases of the Inflam Response

Early-phase response:
Local vasodilatation
______ vascular permeability
Redness

Increased

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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

asthma

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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.

Bronchial contraction

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.

wheezing

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.

cough

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.

dyspnea,

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.

hypoxemia

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.

mast cell degranulation

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 ______ _______

histamine release.

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.

Late Phase

Phases of the Inflam Response Late-phase response: Develops ___-___ ____ later. Much more difficult to resolve than early-phase response.

6 to 8 hours

Whats more difficult to resolve late phase or early phase?

Late Phase

Phases of the Inflam Response Late-phase response: _______ of mucus. Increased vascular permeability

Hypersecretion

Phases of the Inflam Response Late-phase response: Treatment is aimed at stopping inflammatory progression ____ it occurs at this stage.

Before

Phases of the Inflam Response Late-phase response: Hypersecretion of mucus. ______ vascular permeability

Increased

Phases of the Inflam Response Late-phase response: Hypersecretion of mucus. Increased vascular_______

permeability

Phases of the Inflam Response Late-phase response: Hypersecretion of mucus. Increased ______ permeability

vascular

Phases of the Inflamm Response _____ _____ Leukotrienes and prostaglandins are released.

Mucus plugging.

Phases of the Inflamm Response Mucus plugging. _______ and prostaglandins are released.

Leukotrienes

Phases of the Inflamm Response Mucus plugging. Leukotrienes and ______ are released.

prostaglandins

Phases of the Inflamm Response Mucus plugging. Leukotrienes and prostaglandins are_______

released.

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

inflammatory

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

immune response

______: Local dilation of blood | vessels, occurring in seconds

Redness

Redness: Local dilation of blood | vessels, occurring in _____

seconds

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

Flare

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

15 to 30

____: Local swelling, occurring in | minutes

Wheal

Wheal: _____ _____, occurring in | minutes

Local swelling

Wheal: Local swelling, occurring in | _____

minutes

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

increased

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

surrounding tissues

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

Leukocytic

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

White cells

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

capillary walls

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

diapedesis

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

chemotaxis

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

Phagocytosis

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

White cells; macrophages

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

ingest

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

Mediator cascade

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

Histamine

``` 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 ```

chemoattractant

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

complement

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

arachidonic acid

Most common inflammation in the airway

Chronic Bronchitis | Asthma

``` 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 ```

glucocorticoids

``` 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 ```

basal

``` 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 ```

hyperresponsiveness

``` 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 ```

predisposition

acute

Assess for presence of side effects of inhaled steroid therapy ``` Oral thrush Hoarseness Voice changes cough/wheezing with MDI Use of reservoir with MDI ```

killl meeee

Assess for presence of side effects of inhaled ______ therapy ``` Oral thrush Hoarseness Voice changes cough/wheezing with MDI Use of reservoir with MDI ```

steroid

Assess for presence of side effects of inhaled steroid therapy ``` _____ _____ Hoarseness Voice changes cough/wheezing with MDI Use of reservoir with MDI ```

Oral thrush

Assess for presence of side effects of inhaled steroid therapy ``` Oral thrush Hoarseness ___ _______ cough/wheezing with MDI Use of reservoir with MDI ```

Voice changes

Assess for presence of side effects of inhaled steroid therapy ``` Oral thrush _______ Voice changes cough/wheezing with MDI Use of reservoir with MDI ```

Hoarseness

Assess for presence of side effects of inhaled steroid therapy ``` Oral thrush Hoarseness Voice changes ______/____ with MDI Use of reservoir with MDI ```

cough/wheezing

Assess for presence of side effects of inhaled steroid therapy ``` Oral thrush Hoarseness Voice changes cough/wheezing with MDI Use of ______ with MDI ```

reservoir

_______ Side effects ``` Renal insufficiency Extrapulmonary allergy Acute asthma HPA suppression (minimal) Growth retardation Osteoporosis ```

SYSTEMIC

SYSTEMIC ``` _____ _______ Extrapulmonary allergy Acute asthma HPA suppression (minimal) Growth retardation Osteoporosis ```

Renal insufficiency

SYSTEMIC ``` Renal insufficiency Extrapulmonary allergy _____ asthma HPA suppression (minimal) Growth retardation Osteoporosis ```

Acute

SYSTEMIC ``` Renal insufficiency ______ allergy Acute asthma HPA suppression (minimal) Growth retardation Osteoporosis ```

Extrapulmonary

SYSTEMIC ``` Renal insufficiency Extrapulmonary allergy Acute asthma ____suppression (minimal) Growth retardation Osteoporosis ```

HPA

SYSTEMIC ``` Renal insufficiency Extrapulmonary allergy Acute asthma HPA ________ (minimal) Growth retardation Osteoporosis ```

suppression

SYSTEMIC ``` Renal insufficiency Extrapulmonary allergy Acute asthma HPA suppression (_____) Growth retardation Osteoporosis ```

minimal

SYSTEMIC ``` Renal insufficiency Extrapulmonary allergy Acute asthma HPA suppression ____ ________ Osteoporosis ```

Growth retardation

SYSTEMIC ``` Renal insufficiency Extrapulmonary allergy Acute asthma HPA suppression (_____) Growth retardation _________ ```

Osteoporosis

______ Side Effects Oropharyngeal fungal infections Dysphonia Cough, bronchoconstriction Incorrect use of MDI

LOCAL

LOCAL Side Effects _______ fungal infections Dysphonia Cough, bronchoconstriction Incorrect use of MDI

Oropharyngeal

LOCAL Side Effects Oropharyngeal fungal infections ________ Cough, bronchoconstriction Incorrect use of MDI

Dysphonia

LOCAL Side Effects Oropharyngeal ______ infections Dysphonia Cough, bronchoconstriction Incorrect use of MDI

fungal

LOCAL Side Effects Oropharyngeal fungal infections Dysphonia Cough, __________ Incorrect use of MDI

bronchoconstriction

LOCAL Side Effects Oropharyngeal fungal infections Dysphonia ______, bronchoconstriction Incorrect use of MDI

Cough

LOCAL Side Effects Oropharyngeal fungal infections Dysphonia Cough, bronchoconstriction _____ use of MDI

Incorrect

LOCAL Side Effects Oropharyngeal fungal infections Dysphonia Cough, bronchoconstriction Incorrect use of ____

MDI

_____ suppression not seen in doses | < 800 ug

Adrenal

Adrenal _______ not seen in doses | < 800 ug

suppression

Adrenal suppression not seen in doses | < ____ __

800 ug

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

complementary

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

glucocorticoids

Evidence of a beneficial, complementary | interaction between glucocorticoids and____-_____ ______

β-adrenergic agonists

_____ increase β2-adrenergic receptor | transcription

Steroids

Steroids_____ β2-adrenergic receptor | transcription

increase

Steroids increase____-_____ receptor | transcription

β2-adrenergic

steroids increase β2-adrenergic receptor | ______

transcription

______ corticosteroid therapy can provide partial protection against development of tolerance

Inhaled

Inhaled corticosteroid therapy can provide _____ _____ against development of tolerance

partial protection

Inhaled corticosteroid therapy can provide partial protection against development of _____

tolerance

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

Salmeterol

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

binding

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

glucocorticoid

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

nuclear DNA

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

response

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

Intranasal

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

orally | inhaled

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

Intranasal corticosteroids

Systemic administration of ______ ``` Suppression of the HPA axis immunosuppression Psychiatric reactions Cataract formation Myopathy of striated skeletal muscle Peptic ulcer ```

steroids

Systemic administration of steroids ``` Suppression of the___ ___ immunosuppression Psychiatric reactions Cataract formation Myopathy of striated skeletal muscle Peptic ulcer ```

HPA axis

Systemic administration of steroids ``` Suppression of the HPA axis _________ Psychiatric reactions Cataract formation Myopathy of striated skeletal muscle Peptic ulcer ```

immunosuppression

Systemic administration of steroids ``` Suppression of the HPA axis immunosuppression ______ reactions Cataract formation Myopathy of striated skeletal muscle Peptic ulcer ```

Psychiatric

Systemic administration of steroids ``` Suppression of the HPA axis immunosuppression Psychiatric reactions Cataract formation Myopathy of striated skeletal muscle ____ ____ ```

Peptic ulcer

Systemic side effects with _____ administration Of major concern: HPA suppression Loss of bone density Growth restriction in children

aerosol

Systemic side effects with aerosol administration Of major concern: ____ ______ Loss of bone density Growth restriction in children

HPA suppression

Systemic side effects with aerosol administration Of major concern: HPA suppression _____ ___ ____ ____ Growth restriction in children

Loss of bone density

Systemic side effects with aerosol administration Of major concern: HPA suppression Loss of bone density _____ _____ _____ _____

Growth restriction in children

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

Steroids

``` Clinical Application of Aerosol Steroids Use in_____ Early use in asthma For acute severe asthma Clinical use of inhaled corticosteroids ```

asthma

``` Clinical Application of Aerosol Steroids Use in asthma Early use in asthma For acute severe asthma Clinical use of inhaled ______ ```

corticosteroids

Clinical Application of Aerosol Steroids Use in _____ Relieves symptoms Little or no effect on FEV1

COPD

Clinical Application of Aerosol Steroids Use in copd Relieves symptoms Little or no effect on _____

FEV!

Inahled corticosteroid Controller or Rescue

Controller

Steroid Dependency | Classified into two forms:

Physiologic - Psychological

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

Psychological

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

Physiologic

Cortico Steroids Flashcards

(136 cards)