Adrenal steroids

Question 1

Anti-inflammatory mechanisms of GCs (4)

Answer 1

1. enhance vasoconstriction –> decrease redness and swelling
2. inhibit arachidonic acid metabolites–> redue fever and pain
3. complex leukocyte effect–> decrease inflammation and defense
4. Alter release of cytokines and inflammatory mediators

Question 2

short duration, GC and MC effects, mild inflammation

Answer 2

hydrocortisone

Question 3

intermediate duration, less MC effects

Answer 3

Prednisone

Question 4

long duration little MC effect

Answer 4

Dexamethasone

Question 5

MC drug

Answer 5

Fludrocortisone

Question 6

MC antagonist, diuretic

Answer 6

Spironolactone

Question 7

Most commonly used GC drug

Answer 7

Prednisone

Question 8

GC more potent due to lack of protein binding

Answer 8

Dexamethasone

Question 9

Delivery of GCs

Answer 9

Can be taken orally, parenteral, localized delivery important for anti-inflammatory effects

Question 10

MC adverse effects

Answer 10

water retention, hypertention, edema

hypernatremia (high Na+), hypokalemia (low K+), alkalosis (low H+)

Question 11

Most important contra-indications of GCs

Answer 11

heart disease, hypertension, diabetes, peptic ulcer, infections, osteoperosis, glaucoma, psychoses, all use in children

Question 12

Critical therapeutic issues

Answer 12

may become dependent, must decrease dose slowly