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Corticosteroids Flashcards

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1
Q

What are the 3 different steroid hormones

A

Glucocorticoids, mineralcorticoids, sex steroids

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2
Q

Glucocorticoids

A

essential during stress, down regulates immune ststerm activity

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3
Q

Mineralcorticoids

A

essential for liffe, regulate Na/K levels

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4
Q

Sex steroids

A

androgens, estrogens, progestogens

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5
Q

What are corticosteroids synthesized from?

A

cholesterol within the adrenal cortex

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6
Q

What are most steroidgenic rxns catalyzed by

A

enzymes in the cytochrome P450 family

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7
Q

What are the physiological actions of glucocorticoids

A

metabolic effects

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8
Q

what are the pharmocological effects of glucocorticoids

A

anti-inflammatory, immunosuppressive and anti anaphylaxis, anti-shock, hematologic

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9
Q

What are the adverse effects of glucocorrticoids

A

GI, CNS exciting effects

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10
Q

What are the carb metabolism effects of corticosteroids

A

inc gluconeogenesis, dec peripheral utilization of glucose, inc glycogen deposition in liver

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11
Q

what are the protein metabolism effects of corticosteroids

A

breakdown of protein, mobilization of amino acid from periphery, negative nitrogen balance

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12
Q

Effects of carb and protein metabolism results in

A

diabetes like state state resistant to insulin, increased urea production, wasting of muscle lympholysis, thinning of skin

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13
Q

Effects of fat metabolism

A

increased lipolysis, decreased lipogenesis, inc breakdown of TGA, redistribution of fat- moon face

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14
Q

effects on electrolyes and H2O

A

enhanced Na reabsorption from the distal tubules of the kidney, will lead to fluid retention, an association inc in urinary excretion of K and H+, edema and hypertension common

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15
Q

What is the effect on anti-anaphylaxis

A

inhibits histamine release by basophils/mast cell

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16
Q

Antishock effects

A

dec inflammatory factors release, inc body resistance to bacterial endotoxin, permissive role as a vasopressor (effects angotensin), inc myocardial contractibility

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17
Q

Hematologic effects

A

stimulates hematopoiesis in bone marrow, RBC inc, Hgb inc, PLT inc

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18
Q

What do steroids do to the GI

A

increase gastric acid, increase pepsin

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19
Q

What do steroids do to the CNS

A

euphoria, can cause seizures at high doses, insomnia but rare

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20
Q

Symptoms of addison’s disease

A

fatigue, orthostatic hypotension, wt loss, changes in mood, arthralgias, hyperpigmentation

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21
Q

Lab abnormalities of addison disease

A

hyponatremia, hyperkalemia, hypercalcemia, hypoglycemia, eosinophilia, lymphocytosis, metabolic acidosis

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22
Q

What is treatment for addisons

Study These Flashcards
A

replace cortisol with hypdocortisone or prednisone, replace aldosterone with fludocortisone

23
Q

What is a test for cushings

Study These Flashcards
A

dexamethasone suppresion test

24
Q

Treatment for cushings

Study These Flashcards
A

taper and stop corticosteroids, remove tumore if needed, ketoconazole, mifepristone

25
Injectable steroids
betamethasone, dexamethosone, hydrocortisone, methylprednisolone, prednisolone, triamcinolone
26
Oral steroids
betamethasone, fludrocortisone, methylprednisolone, prednisolone, prednisone
27
Inhaled steroids
advair, symbicort, azmacort, asmanex twisthaler, flovent, aerobid, pulmicort, QVAR
28
What are uses of hydrocortisone
antiinflammatory, replacement, shock, status asmaticus, ulcerativve colitis, crohns, thyroid storm
29
Dosage of hydrocortisone
100 mg IV TID-QID, 20 mg PO daily, rapid but short acting
30
Predisone/Predisolone uses
allergy, asthma, COPD, autoimmune, inflammation, malignancy
31
What is DOC steroid for peds
prednisone
32
Dosage of prednison
Chronic- 5-20 mg PO daily, if acute must taper 60 mg TID down to 10 mg PO TID
33
Methylprednisolone uses
allergy, antiinflammatory, asthma, COPD, immunosuppressive, pulse therapy in non responsive RA, renal transplant
34
What is potency and selectivity of methylprednisolone
more potent, GC selective
35
Dosage of methylprednisolone
IV- 125 mg QID- aggressive; 60 mg TID middle; 40 mg BID low; can go up to 250 mg QID
36
Triamcinolone use
arthritis injection, dermatoses, hay fever, MS
37
What is potency and selectivity of triamcinolone
potent and GC selective
38
Dexamethosone uses
antiemetic, cerebral edema, cushings, dexamethasone suppression test, MS, inflammayion, allergy, physiological replacement, shock
39
Pearls of dexamthasone
very potent, highly selective GC, causes HPA suppression
40
Betamethasone uses
bursitis, dermatologic, MS, peritendinitis, tenosynovitis, RA OA
41
Betamehtasone PEARL
very potent selective GC
42
Fludrocortisone use
congenital adrenal hyperplasia, orthostatic hypotension, replacement for Addison's
43
Pearl of fludrocortisone
potent MC, some GC, dont use for inflammation or immunosuppression
44
what renal diseases can steroids treat
nephrotic syndrome in children, renal disease ssecondary to SLE, renal sarcoidosis, glomerulonephritis
45
What other immunosuppressants are steroids combined with for organ transplant
cyclosporine, azathioprine
46
What infectious dissease can steroids treat
AIDs and pneumocystis carinii pneumonia, haemophilus influenza meningitis, tubercular meningitis, sepsis
47
Steroids are essential for what malignancy
ALL, hodgkin's or other lymphoma, hormone responsive breast cancer, can provide symptomatic relief in other CA
48
Other uses of steroids
acute mountain sickness, aspiration pneu, pulmonary edema, cerebral edema, thyroid storm, idiopathic thrombocytopenic purpura
49
Short term admin ADRs
insomnia, inc appetite, wt gain, behavioral, peptic ulcer
50
Steroid withdrawal
weakness, fatigue anorexia, arthralgias, wt loss, NVD, hypoglycemia, fainting, hypotension, shock, death
51
Warnings of steroids
CVD, DM, peptic ulcer, hepatic impairment, MI, osteoporosis, seizure disorder, glaucoma, infection, HTN
52
Contraindication of steroids
systemic fungal infection
53
Long term steroid ADR
CVD, metabolc, endocrine, skeletal, GI, hypokalemia, neuropsychiatric, immune function

Pharmacology (61 decks)

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