Pharm 20- Glucocorticoids & Immunosuppressants Flashcards Preview

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Flashcards in Pharm 20- Glucocorticoids & Immunosuppressants Deck (46)
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1

In stress, hypothalamus releases what?

Corticotropin-releasing factor

2

Corticotropin-releasing factor acts on what part of the body?

Anterior pituitary

3

Anterior pituitary releases what?

Cortiocotropin (ACTH)

4

Corticotropin (ACTH) acts on what? Which then releases what?

Adrenal Medulla; aldosterone/cortisol/androgens

5

Whats the classic stress hormone?

Glucocorticoids

6

What do glucocorticoids do?

Promote gluconeogenesis, protein catabolism, and lipolysis; which allows critters to respond to overwhelmingly stressful situations

POTENT anti-inflammatory (NOT analgesic)

7

Glucorticoids result in what physiologically?

Vasoconstriction, glucose release
Break down fat and muscle (lipolysis) to produce more glucose and the need for more glyconeogenesis

8

Why are glucocorticoids insulin antagonists?

They inhibit the uptake of glucose by fat and muscle and increase hepatic glucose output

9

What is an adverse affect of glucocorticoids?

Decrease WBC #'s
All are immunosuppressive even as a single dose

10

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

11

Anabolic

construct molecules from smaller units

12

Describe the "feedback inhibition" of glucocorticoids.

Causes feedback inhibition of further glucocorticoid and thyroid-stimulating hormone production

13

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

14

Effects of Glucocorticoids at high doses

Bone density loss
Myopathy
Steroid rage and personality changes
Gastric Ulcers
Diabetogenic
Moon Face & Humpback

15

What is hyperglucocorticism?

Cushing Syndrome

16

What is hypoglucocorticism?

Addison's Disease

17

What is the archetypical glucocorticoid?

Cortisol, given a value of "1" when comparing anti-inflammatory and salt-retaining properties

18

What is the half-life of cortisol?

1-2 hours

19

Another name for cortisol?

Hydrocortisone

20

List the Glucocorticoids.

Hydrocortisone (Solu-Cortef)
Dexamethasone (Decadron)
Prednisone
Prednisolone
Methylprednisolone (Medrol)

21

Which (Short-acting) glucocorticoids do we care about for bypass?

Hydrocortisone
Cortisone
(1-12 hours)

22

When would we use long acting glucocorticoids? Name them.

Transplant patient; immunosuppressed for a long time. Bethamethasone, Dexamethasone
(36-55 hours)

23

What are the two general immunosuppressant categories?

1. Induction Drugs: Used at the time of transplanation
2. Maintenance Drugs: Required for long term immunosuppresion

24

What are the 5 Major pharmacological classes of Immunosuppressives

1. Glucocorticoids
2. Calcineurin Inhibitors
3. mTOR Inhibitors
4. Antiproliferative Agents
5. Monoclonal Antibodies

25

What is a standard component of induction and maintenance? (high doses initially tapering over time)

Glucocorticoids

26

What is the drug of choice for moderate rejection episodes?

Glucocorticoids

27

What do glucocorticoids suppress?

T-lymphocytes

28

Calcineurin Inhibitors

Cyclosporin (Sandimmune)
Tacrolimus (Prograf)

29

Calcineurin

Major T-cell activator

30

What is the break through drug that allowed transplants to successfully occur?

Cyclosporin