Flashcards in Pharm 20- Glucocorticoids & Immunosuppressants Deck (46)
In stress, hypothalamus releases what?
Corticotropin-releasing factor acts on what part of the body?
Anterior pituitary releases what?
Corticotropin (ACTH) acts on what? Which then releases what?
Adrenal Medulla; aldosterone/cortisol/androgens
Whats the classic stress hormone?
What do glucocorticoids do?
Promote gluconeogenesis, protein catabolism, and lipolysis; which allows critters to respond to overwhelmingly stressful situations
POTENT anti-inflammatory (NOT analgesic)
Glucorticoids result in what physiologically?
Vasoconstriction, glucose release
Break down fat and muscle (lipolysis) to produce more glucose and the need for more glyconeogenesis
Why are glucocorticoids insulin antagonists?
They inhibit the uptake of glucose by fat and muscle and increase hepatic glucose output
What is an adverse affect of glucocorticoids?
Decrease WBC #'s
All are immunosuppressive even as a single dose
Are glucocorticoids catabolic steroids or anabolic steroids? Why?
Catabolic steroids; because they involve the breakdown of complex molecules in living organisms to form simpler ones
construct molecules from smaller units
Describe the "feedback inhibition" of glucocorticoids.
Causes feedback inhibition of further glucocorticoid and thyroid-stimulating hormone production
What's important to note about discontinuing glucocorticoids, based on the feedback inhibition?
Wean off little by little bc instead of having too much you'll have none
Effects of Glucocorticoids at high doses
Bone density loss
Steroid rage and personality changes
Moon Face & Humpback
What is hyperglucocorticism?
What is hypoglucocorticism?
What is the archetypical glucocorticoid?
Cortisol, given a value of "1" when comparing anti-inflammatory and salt-retaining properties
What is the half-life of cortisol?
Another name for cortisol?
List the Glucocorticoids.
Which (Short-acting) glucocorticoids do we care about for bypass?
When would we use long acting glucocorticoids? Name them.
Transplant patient; immunosuppressed for a long time. Bethamethasone, Dexamethasone
What are the two general immunosuppressant categories?
1. Induction Drugs: Used at the time of transplanation
2. Maintenance Drugs: Required for long term immunosuppresion
What are the 5 Major pharmacological classes of Immunosuppressives
2. Calcineurin Inhibitors
3. mTOR Inhibitors
4. Antiproliferative Agents
5. Monoclonal Antibodies
What is a standard component of induction and maintenance? (high doses initially tapering over time)
What is the drug of choice for moderate rejection episodes?
What do glucocorticoids suppress?
Major T-cell activator