3 - Steroids Flashcards
What are the functions of natural cortisol?
- Regulation of carbohydrate, fat and protein metabolism
- Maintenance of vascular reactivity
- Anti-inflammatory
- Homeostasis during stress
What is the most potent activator of stress?
Surgery
& pain cause an increased level of endogenous cortisol
What are the diseases of excess and insufficient cortisol production?
- Excess
- Cushing’s disease (primary)
- Insufficient
- Addison’s disease (primary)
- Secondary = HPA axis suppressed from taking glucocorticoids
What causes a secondary disorder of adrenal insufficiency?
Secondary = HPA axis suppressed from taking glucocorticoids
What are the common signs of adrenal crisis?
- Profuse sweating
- Hypotension
- Weak pulse
- Dyspnea
- Cyanosis
What are synthetic glucocorticoid medications indicated for?
- Autoimmune diseases
- Immunosuppressive therapy - organ transplant
- Respiratory disease management
What’s the mechanism of action of steroids?
- Anti-inflammatory effects
- Peripheral leukocytes decrease
- Inhibits phospholipase A
- Lowers prostaglandins and leukotrines
How are steroids rated?
As to potency compared to hyrdocortisone equivalent dose
The more potent the steroid - The…?
- lower the dose
- higher the risk for adrenal suppression
How are equivalent doses based?
On 20mg hydrocortisone = amount normally secreted daily by an adult without stress
What are the short acting corticosteroids?
- hydrocortisone
- prednisone
- methylprednisolone
What are the intermediate acting corticosteroids?
- triamcinolone
- prednisolone
What are the long acting corticosteroids?
- dexamethasone
- betamethosone
What is alternate day therapy used with steroids used for?
Patients who must take steroids for longer than 1 month
Any medication that exceeds the normal adrenal output amount of cortisol may cause suppression, what is that dosage?
20-30 mg
