A - 6. Glucocorticoids for oral and parenteral use

Question 1

Glucocorticoids origin

Answer 1

Zona fasciculata on adrenal cortex

Question 2

Glucocorticoids feedback

Answer 2

Inihibits both hypothalamus (CRH release) and pituitary (ACTH) release

Question 3

Cortisol main functions

Answer 3

Regulation of immune response
- inhibits IL-2 -> decreased T-cell prolifiration

Metabolism

• lipolysis and proteolysis -> gluconeogenesis
• increases insulin resistance

Blood pressure
- Upregulation of a1 receptors -> vasoconstriction

Question 4

Indications for glucocorticoid treatment

Answer 4

Addisons
Rheumatoid arthritis
As immunosuppressants - asthma, SLE, other autoimmune diseases

Question 5

Short acting glucocorticoids

Answer 5

Hydrocortisone (acts fast, low duration)

IV, IM, oral, topical

Question 6

Intermediate acting glucocorticoids; names

Answer 6

Prednisone
Prednisolone
Methylprednisolone
Triamcinolone

Question 7

Intermediate acting glucocorticoids; indications

Answer 7

Anti inflammatory
- acute asthma

Autoimmune conditions
- rheumatoid arthritis

IV, oral, IM
4x more potent than hydrocortisone -> lower doses

Question 8

Long acting glucocorticoids

Answer 8

Dexamethasone

Oral, IV, IM or inhaled
Very potent
Used for diagnosis in Cushings (suppression test)

Question 9

SE

Answer 9

Cushings like symptoms - iatrogenic cushings