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Flashcards in Corticosteroids Deck (18)
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1

What glucocorticoids have mineral corticoid effects? What are these effects?

Prednisone and cortisol, Na retention

2

Cortisol Physiological Actions

Activates gluconeogenesis and hyperglycemia
Activates catabolsim of protein and lipids
Maintains blood volume
Maintains vascular function (BP)
Anti-inflammatory/Immunosuppression

3

Where does cortisol bind?

GRE in the nucleus which increases liver gluconeogenesis, protein catabolism genes and liver catabolism genes

4

How does cortisol have repression of anti inflammatory?

When GRE gets to NFKB there is a decrease in prostaglandins, leukotrienes and cytokines

5

Effects of corticosteroids on immune cells

1. inhibition of migration from vascular spine to site of injury (decreased adhesion molecules for leukpcyte localization)
2. inhibition of phospholipase A2 and cyclooxygenase-2(decreases prostaglandins and leukotrienes)

6

Effects of corticosteroids on mast cells and basophils

decrease histamine release

7

Effects of corticosteroids on monocytes and macrophages

decrease production of proinflamatory cytokines, decreases chemotaxis response, and decreased differentiation into macrophages

8

corticosteroid effects on lymphocytes

decreased t cell response to antigens, mitogen, decreased proliferation, and decreased proinflammatory expression

9

net effect of cortico steroids on immune suppression

immunosupression, anti-inflammatory (palliative care not curative), decrese pain and tissue destruction

10

short acting cortico steroids

cortisol

11

intermediate acting corticosteroids

prednisone, triamcinolone

12

long acting corticosteroids

dexamethasone and betamethasone

13

other corticosteroids

fluticasone- inhaled (reduces systemic effects))
fluocinonide - topical

14

toxicity of corticosteroids

continued use or via withdrawal

15

conintued use of corticosteroids

iatrogenic cushings (HTN, susceptibility to infection, osteoporosis, Gi ulcers)

decrease resposne to stress

16

withdrawal of cortico steroids

the adrenal gland may take 2-6 mo. to recover so going cold turkey can have negative side effects such as nausea shock and hypotension

17

dosing schedule for corticosteroids

tapering dose and alternate day dosing, prevents flare inflammatory response

18

Therapeutic indications

anti-inflammatory