systemic steroids Flashcards
(24 cards)
what are the endogenous
cortisol
aldosterone
what are cortisol and aldosterone replaced with
c: gluco
a: mineral (fludro)
what are mineralcorticoids (fludro) mostly used for
addisons
ortho BP
what is cushings
too much cortisol or high steroid intake
steroid mnemonic
Cute-cortisone 25mg
Hot- hydrocortisone 20mg
Pharmacists-prednisone 5 mg
and
Physicians-prednisolone 5 mg
Marry- methylprednisone 4 mg
Together- triamcinolone 4 mg
and
Deliver- dex 0.75mg
Babies- betamethasone 0.6
what are the short term SE
wt gain, insomnia, inc BP/BG
worsen glaucoma, DM
> how many mg/kg/day of steroids can lead to immunosuppression
2 mg/kg/day
OR 20mg/kg/day of pred or pred equ for 2 weeks
if you are immunosuppressed you should not receive what
live vax
is rheumatoid arthritis unilateral or bilateral
bilateral
what are the drug tx options for RA
1st line: methotrexate
then steroids/NSAIDS (used to bridge until DMARD take effect)
if RA is mod-sev while on metho, what can you use in combo
anti TNF or non-bio DMARDs
what does methotrexate inhibit
inhibit dihydrofolate
how often is the metho dose taken
weekly low dose
what should you supplement with while on MTX
folic acid
-take on DAY AFTER MTX dose
what is the folic acid dose
5 mg or 1mg/day but skip on day of mtx
what are the non-biologic DMARDs that can be used with or w/o MTX
hydroxychloroquine
sulfasalazine
hydroxy causes what
N/V/D
-take with food and milk
what are some SE of MTX
inc LFTs
stomatitis
alopecia
hydroxychloroquine can be used as an alt to MTX if youre worried about what
liver damage
hydroxy can cause irreversible what
eye damage
what is the treatment for systemic lupus
-steroids
-hydroxy
-cyclophos, azathio, myco, cyclo
what are the ANTI-TNF bio
-etanercept (enbrel): weekly
-adalimumab (humira)- q other week
-infliximab (remicade)- w MTX- NS only
-golimumab (simponi)-monthly w MTX
what is the DOC for raynauds
nifedipine or other CCB
what are the drugs of choice for dry mouth
muscarinic agents
-pilocarpine
-cevimeline
