Corticosteroids Flashcards Preview

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Flashcards in Corticosteroids Deck (26):
1

prednisone

glucocorticoid

2

cortisol

glucocorticoid

3

aldosterone

mineralocorticoid

4

steroid hormones

lipophilic
-very hydrophobic

5

basal levels of glucocorticoids

diurnal

high in morning

6

cortisol feedback

negative on anterior pituitary and hypothalamus

also - inhibit immune system - lymphocytes, macros, monos, neutros

7

secondary adrenocortical insufficiency

iatrogenic

prolonged steroid therapy - HPA suppression

need gradual withdrawal**

8

cortisol effects

increase plasma glucose
breakdown of lipid
breakdown of protein
increased vasoconstriction
more RBCs, platelets, MPNs
less eosinos, basos, monos, lymphos

inhibition of inflammatory mediators**
-prostaglandinds, leukotrienes, COX-2, mast cell
-decreased peripheral lymphos and macro activation

9

permissive effects

glucocorticoids induce proteins required for signal transduction by other hormones

establish endocrine set points or sensitivity for stimulation

10

mineralocorticoid specificity

MR - enzymatic protection so don't respond to cortisol (which is always high)

11 beta hydroxysteroid dehydroxygenase

11

11 beta hydoxysteroid dehydroxygenase

converts cortisol to cortisone

in tissues that need aldosterone response to MR receptors and not high response to cortisol

12

glucocorticoids and inflammation

inhibit production and release of cytokines that normally stimulate proliferation and function of B and T cells

lipocortin mediated inhibition of PLA2

suppression/distribution of leukocytes

immune/CNS feedback

13

phospholipase A2

inhibited by corticosteroids

no arachidonic acid
-stops multiple downstream effects

inhibits multiple prostaglandin pathways

14

long acting steroids

betamethasone
dexamethasone

15

short acting steroids

cortisol
cortisone

16

mineralocorticoid steroids

corticosterone
fludrocortisone

17

intermediate acting steroids

more at glucocorticoid receptors

prednisone
prednisolone
methylprednisolone
triamcinolone

18

long acting very potent glucocorticoid

dexamethasone**

betamethasone

19

addisons disease

fludrocortisone**

corticosterone

20

triamcinolone

inhalation for asthma

21

dexamethasone

very potent

22

toxicity of corticosteroids

long term use - HPA axis suppression

23

corticosteroid

single dose or short course - no harmful effects

longer than 1 week - adverse weeks occur

24

alternate day therapy

minimize HPA suppression

25

pulse therapy

life-threatening conditions

initial dose large - if doesn't work - us 2x or 3x dose

26

inhaled corticosteroids

low toxicity