Exam 3 Flashcards
(112 cards)
1
Q
another name for corticosteroids?
A
glucocorticoids
2
Q
hormones produced by adrenal cortex?
A
corticosteroids
3
Q
where are glucocorticoids produced?
A
adrenal cortex
4
Q
inadequate or excess secretion of corticosteroids results in what?
A
disease
5
Q
how many steroid hormones does adrenal cortex produce?
A
30
6
Q
what are the three classes of adrenal cortex hormones?
A
glucocorticoids, mineralocorticoids, adrenal sex hormones
7
Q
effect of GCs on arachidonic acid metabolism?
A
inhibit
8
Q
effect of GCs on biologic membranes?
A
strengthens or stabilizes
9
Q
effect of GCs on interleukin-1 production?
A
inhibit
10
Q
effect of GCs on tumor necrosis factor production?
A
inhibit
11
Q
effect of GCs on other cytokines?
A
inhibit
12
Q
effect of GCs on phagocytosis?
A
impairs
13
Q
effect of GCs on lymphocytes?
A
impairs
14
Q
effect of GC on tissue repair?
A
inhibits
15
Q
symptoms of what? Malaise, myalgia, nausea, headache, low grade fever, relapse of symptoms, hypotension
A
GC withdrawal
16
Q
prototype GC?
A
hydrocortisone
17
Q
what is the exogenous equivalent of endogenous cortisol?
A
hydrocortisone
18
Q
drug? Bind to glucocorticoid receptors in target tissues
A
hydrocortisone
19
Q
when are short term GCs indicated?
A
self-limiting conditions
20
Q
when are long term GCs indicated?
A
life-threatening conditions or severe disabling symptoms
21
Q
how long is ‘short-term’ gc USE?
A
<1 WEEK
22
Q
dosing of short term GCs?
A
large divided doses for 48-72 hours, then tapered until discontinued
23
Q
during what hours should GC replacement therapy be admin?
A
6-9 am daily
24
Q
describe alternate-day GC therapy?
A
double dose taken every other day in the morning
25
when is alternate-day GC therapy used?
only for maintenance therapy
26
can corticosteroids be stopped suddenly?
no
27
what should be used over systemic steroid therapy if possible?
local
28
what GC is used for replacement therapy for adrenal cortical insufficiency?
prednisone
29
what GC may be used for severe allergic and anaphylactic reactions?
prednisone
30
what GC may be used for acute exacerbation of chronic diseases? (asthma, COPD)
prednisone
31
what GC may be used for RA?
prednisone
32
what GC may be used for hematologic disorders?
prednisone
33
what GC may be used for thrombocytopenia purpura?
prednisone
34
what GC may be used in neoplastic disease?
prednisone
35
what GC may be used for ulcerative colitis?
prednisone
36
what GC may be used for Cronhn's disease?
prednisone
37
during what hours should prednisone be taken?
6-9 am
38
normal signs of WHAT may be suppressed by prednisone?
infection
39
what are two medication options to help avoid prednisone GI irritation?
ranitidine or omeprazole
40
what should we do to steroid dose with increased stress? (surgery)
increase dosage
41
careful assessment of WHAT with prednisone?
wound healing
42
prednisone suppresses physiologic response to WHAT?
infection
43
what medication may lead to increased susceptibility to TB?
prednisone
44
what medication may lead to increased susceptibility to herpes virus?
prednisone
45
what medication may lead to increased susceptibility to varicella virus?
prednisone
46
what medication may cause acne?
prednisone
47
what medication may delay would healing?
prednisone
48
how does prednisone cause osteoporosis?
calcium loss from the bone
49
increased risk of fracture- what endocrine med?
prednisone
50
effect of prednisone on sodium?
sodium retention
51
effect of prednisone on fluid?
fluid retention
52
effect of prednisone on blood glucose?
increased
53
anxiety and insomnia are associated with what medication?
prednisone
54
what medication may exacerbate gastric ulcers?
prednisone
55
two GI complaints with prednisone?
nausea and vomiting
56
diabetics on prednisone, need more what?
insulin
57
non-diabetics are also susceptible to WHAT on prednisone?
increased blood sugar
58
non-diabetics may also need what while on prednisone?
short term sliding scale insulin
59
two contraindications to prednisone?
allergy and infection
60
what GC is given for poison ivy?
methylprednisolone dose pack
61
what drug? Given IV short term management of acute problems such as asthma
methylprednisolone sodium succinate (solumedrol)
62
what drug? Short term use requiring maximum anti-inflammatory activity?
dexamethasone
63
specific indication example for dexamethasone?
cerebral edema
64
what medication class can be used for joint injection for pain control?
glucorticoids (tissue can become damaged if given too often)
65
what medication have been used in the treatment of patients who are moderately to severely ill with COVID19?
systemic glucocorticoids
66
what two GCs can be used in moderately-severely ill patients with Covid 19?
methylprednisolone and dexamethasone
67
when is insulin used in T1DM?
always
68
what is the one circumstance where insulin is not used in T1DM?
pancreatic transplant
69
when do type 2 DM need insulin?
most patients over time as beta cell function decreases
70
do not wait too long to start what in T2DM?
insulin
71
in what electrolyte imbalance can insulin be used?
hyperkalemia
72
what is the role of insulin to treat hyperkalemia?
insulin + glucose pushes potassium into cells (resolving the hyperkalemia)
73
what two conditions is insulin used for in hospital inpatients?
DKA or hyperosmolar hyperglycemic state
74
WHAT type of insulin therapy is used to maintain normoglycemia when the patient is fasting?
basal
75
what type of insulin therapy is used to cover food ingested before a meal?
bolus
76
what type of insulin therapy is used to decrease elevation of blood glucose after food intake?
bolus
77
basal insulin therapy is used in what type(s) of diabetes?
used in both type1 and type2 (not always initially in type 2)
78
when is bolus insulin therapy used in type 1 DM?
always
79
when is bolus insulin therapy used in type 2 DM?
add when beta cell function is not adequate to respond to food intake
80
basal insulin therapy suppresses what?
any liver gluconeogenesis
81
what are the 6 types of insulin?
rapid-acting, short-acting, intermediate-acting, long-acting, ultra long acting, inhaled
82
insulin lispro is what type of insulin?
rapid-acting
83
insulin aspart is whhat type of insulin?
rapid-acting
84
insulin glulisine- what type of insulin?
rapid-acting
85
name the three rapid-acting insulin analogues?
insulin lispro, insulin aspart, insulin glulisine
86
what is the onset of action of rapid-acting insulin?
15 minutes
87
rapid-acting insulin has a faster onset than what?
endogenous insulin
88
what type of insulins have a faster onset than endogenous insulin?
rapid-acting
89
when are rapid-acting insulins used? (types)
types 1 and 2 DM
90
what is the indication for rapid-acting insulin?
used as bolus therapy to treat hyperglycemia or blood sugar due to food eaten
91
what type of insulin is regular insulin?
short-acting
92
example of short-acting insulin?
regular insulin
93
what is the onset of action of regular insulin?
30 minutes
94
what is the duration of action for short-acting insulin?
4 hours (up to 12 hours)
95
what is the clinically relevant peak of action of regular insulin?
1-2 hours
96
what type of insulin is NPH?
intermediate-acting
97
example of intermediate-acting insulin?
NPH/isophane
98
what types of DM use short-acting insulin?
type 1 and type 2
99
indication of short-acting insulin?
used as bolus therapy to treat hyperglycemia or blood sugar due to food eaten in types 1 and 2 DM
100
onset of action of NPH?
1-1.5 hours
101
duration of action of NPH?
12-24 hohurs
102
what is the usual duration of action of NPH re: clinical efficacy?
16 hours
103
what is the indication for NPH?
used as basal insulin in types 1 and 2 DM
104
examples of long acting insulin?
insulin glargine
105
is insulin glargine an insulin analogue?
yes
106
can long-acting insulin be given IV?
no
107
can you mix insulin glargine with other insulins?
no
108
can you mix insulin detemir with other insulins?
no
109
can you give insulin glargine IV?
no
110
can you give insulin detemir IV?
no
111
how is insulin glargine uniqu?
no pronounced peak of action
112
what are the benefits of insulin glargine re: no peak?
less hypoglycemia and better glycemic control
