adrencorticosteroids Flashcards
these are released from the adrenal cortex
adrenocorticosteroids (aka glucocorticosteroids or steroids). includes glucocorticosteroids and mineralocorticoids
glucocorticoids primarily affect? mineralocorticoids
carbohydrate metabolism. body sodium and water balance.
what is the major glucocorticosteroid in the body? and how much is secreted daily
hydrocortisone (cortisol) = 20 mg daily
what is ACTH, secreted by?
adrenocorticotropic hormone, pituitatry gland, caused release of hormones from the adrenal cortex
what is addisons disease
produced by the deficiency of adrenocorticosteroids.
what is cushing syndrome?
excess of adrenocorticosteroids
what are adrenocorticosteroids
they are naturally occurring hormones
what are medical uses of adrenocorticosteroids?
dentistry: topical/systemic tx of oral lesions of inflammatory disorders
used to treat chronic diseases > can cause adverse reactions that may influence the patient’s dental treatment
what is the mechanism of action of adrenocorticosteroids?
secreted by adrenal cortex, release is triggered by series of events, stimulus caused hypothalamus to release corticotropin-releasing hormone (CRH), CRH acts on pituitary, pituitary releases ACTH, ACTH stimulates cortex to release hydrocortisone, then acts on pituitary to inhibit CRH and ACTH, negative feedback
how do exogenous corticosteroids act
the same way as hydrocortisone
long term use adrenocorticosteroids
suppresses ACTH, adrenal gland atrophies
withdrawal of adrenocorticosteroids can cause
adrenal crisis to occur
what is the MoA for glucocorticosteroids
binds to receptor to form steroid-receptor complex
complex moves into the cells and affects cell processes: inflammation and immune response
this is a life sustaining hormone and its functions
cortisol (major glucocorticoid). blood sugar, fat, carbs, protein metabolism, antiinflammatory, bp and immune,
without cortisol - weakness, loss of consciousness and even death
what are the two classifications of steroids
glucocorticosteroids and mineralocorticoids
exogenous glucocorticoids pharmacological effects
anti-inflammatory, suppression of allergic reactions (anti-allergic, supression of the immune system - palliative not curative
routes of administration
topical, oral, IM, IV
commonality of systemic effects with topical? orally or injection?
T: rare - large quantity and broken skin can happen
O and I: common
Cushing syndrome appearance
thinning of hair, acne, buffalo hump, moon face, pendulous abdomen, slow wound healing
adverse reactions of glucocorticosteroids
hyperglycemia, infections, CNS effects (feeling of euphoria), peptic ulcer, impaired wound healing, opthalmic effects (developing cataracts), electrolyte and fluid balance (sodium and water retention = high bp, adrenal crisis (adrenal suppression)
dental effects of glucocorticosteroids
delayed healing of mucosal surfaces, decreased resistance to infections, oral candidiasis may result from the use of oral steroid inhalers (rinse mouth out so ther dont develop thrush)
medical uses of EC
inflammation/allergy, emergencies, replacement therapies
the most extensive use of EC is for
inflammation/allergy
topical use of EC? oral? (inflammtion/allergy)
t: variety of skin conditions
O: rheumatoid arthritis, acute bronchial asthma, severe and acute allergic reactions, etc
emergency use of EC
tx of shock or adrenal crisis
replacement therapy use of EC
for those with addison disease
dental uses of EC
oral lesions, apthous stomatitis, TMJ pains, oral surgery, pulp procedures
Oral corticosteroids are divided by their
duration of action: short acting, intermediate and long acting
Oral corticosteroid products: short acting?Intermediate acting? Long acting?
S: hydrocortison, prednisone, methylprednisone
I: triamcinolone, prednisolone
L: dexamethasone, betamethasone
antiinflammatory effects from short acting to long acting
decreases and dose decreases as well
which OC is the standard
hydrocortisone
corticosteroids suppress the immune response:
infections are more likely to occur, healing is delayed with chronic use, symptoms of infections may be masked, can make hypertension worse
consideration with salicylates and NSAIDs
use with caution
the preferred analgesic
acetaminphen or tylenol instead bc of GI effects of salicylates and NSAIDs
what should be checked at each visit
BP and pulse, osteoporosis of the jaw and bone, perio
be aware of
adrenal crisis
