Corticosteroids Flashcards
(19 cards)
Name the glucocorticoids
Prednisolone
Dexamethasone
Betamethasone
Deflozacort
Which drugs have the highest glucocorticoid effect
Dexamethasone
Betamethasone
When are glucocorticoids preferred
When fluid retention may be disadvantageous
Side effects of glucocorticoids
Increased blood sugar
Osteoporosis
Avascular necrosis of the femoral head - muscle wasting
Gastric ulceration and perforation
Name the mineralocorticoids
Fludrocortisone
Hydrocortisone
Which drug has the highest mineralocorticoid effect
Fludrocortisone
What is an alternative indication for fludrocortisone
Postural hypotension
Increases fluids which increases BP
What are the side effects of mineralocorticosteroids
Sodium and water retention = HYPERtension
HYPOkalaemia
HYPOcalcaemia
What are the MHRA warnings for corticosteroids
- Early psychiatric side effects
Irritable, mania, anxiety, depressed, sleeping disorders, suicidal thoughts - Central serious chlorioretinopathy
In local and systemic administration
Affects ONE eye blurry and distorted
7 dangers/precautions of corticosteroids
- Adrenalcorticol insufficiency
- Infections susceptiblity
- chickenpox can be fatal
- measles exposure
- Avoid live vaccines
- Avoid in cushings disease
- Rapid intracranial pressure
Why are corticosteroids avoided in Cushings?
What are the effects?
Due to aggravation
Leading to moon face, striae, hirstuism, acne
When can you have a live vaccine after corticosteroid therapy
Postpone until 3 months after stopping
What to do during intercurrent illness, trauma or surgical procedure
Increase/double dose of steroid
Temporary reinteoduction of recently stopped
What is breast feeding guidance on taking steroids
Try to wait 4hrs between dose and BF
What to monitor before starting steroids
BP
Weight/Height BMI
HbA1c/fasting glucose level
Triglycerides
Potassium
Optimetrist assessment
What to monitor during the use of steroids
BP
Height/weight
Triglycerides
HbA1c
Osteoporosis
Falls risk
Adrenal suppression
Eye disorders
When do you not need to withdraw gradually?
Less than 3 weeks can stop abruptly
When do you need to gradually withdraw steroids
More than 40mg prednisolone daily for more than 1 week
Repeated evening doses
More than 3 weeks
Recent repeated courses
Previous long term therapy in past months or years
Other possible causes of adrenal suppression such as excessive alcohol or stress
What is the order of potency for topical steroids
Mild hydrocotrisone
Moderate clobetasone
Potent betametasone
Very potent clobetasol
