adrencorticosteroids

Question 1

these are released from the adrenal cortex

Answer 1

adrenocorticosteroids (aka glucocorticosteroids or steroids). includes glucocorticosteroids and mineralocorticoids

Question 2

glucocorticoids primarily affect? mineralocorticoids

Answer 2

carbohydrate metabolism. body sodium and water balance.

Question 3

what is the major glucocorticosteroid in the body? and how much is secreted daily

Answer 3

hydrocortisone (cortisol) = 20 mg daily

Question 4

what is ACTH, secreted by?

Answer 4

adrenocorticotropic hormone, pituitatry gland, caused release of hormones from the adrenal cortex

Question 5

what is addisons disease

Answer 5

produced by the deficiency of adrenocorticosteroids.

Question 6

what is cushing syndrome?

Answer 6

excess of adrenocorticosteroids

Question 7

what are adrenocorticosteroids

Answer 7

they are naturally occurring hormones

Question 8

what are medical uses of adrenocorticosteroids?

Answer 8

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

Question 9

what is the mechanism of action of adrenocorticosteroids?

Answer 9

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

Question 10

how do exogenous corticosteroids act

Answer 10

the same way as hydrocortisone

Question 11

long term use adrenocorticosteroids

Answer 11

suppresses ACTH, adrenal gland atrophies

Question 12

withdrawal of adrenocorticosteroids can cause

Answer 12

adrenal crisis to occur

Question 13

what is the MoA for glucocorticosteroids

Answer 13

binds to receptor to form steroid-receptor complex

complex moves into the cells and affects cell processes: inflammation and immune response

Question 14

this is a life sustaining hormone and its functions

Answer 14

cortisol (major glucocorticoid). blood sugar, fat, carbs, protein metabolism, antiinflammatory, bp and immune,
without cortisol - weakness, loss of consciousness and even death

Question 15

what are the two classifications of steroids

Answer 15

glucocorticosteroids and mineralocorticoids

Question 16

exogenous glucocorticoids pharmacological effects

Answer 16

anti-inflammatory, suppression of allergic reactions (anti-allergic, supression of the immune system - palliative not curative

Question 17

routes of administration

Answer 17

topical, oral, IM, IV

Question 18

commonality of systemic effects with topical? orally or injection?

Answer 18

T: rare - large quantity and broken skin can happen

O and I: common

Question 19

Cushing syndrome appearance

Answer 19

thinning of hair, acne, buffalo hump, moon face, pendulous abdomen, slow wound healing

Question 20

adverse reactions of glucocorticosteroids

Answer 20

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)

Question 21

dental effects of glucocorticosteroids

Answer 21

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)

Question 22

medical uses of EC

Answer 22

inflammation/allergy, emergencies, replacement therapies

Question 23

the most extensive use of EC is for

Answer 23

inflammation/allergy

Question 24

topical use of EC? oral? (inflammtion/allergy)

Answer 24

t: variety of skin conditions
O: rheumatoid arthritis, acute bronchial asthma, severe and acute allergic reactions, etc

Question 25

emergency use of EC

Answer 25

tx of shock or adrenal crisis

Question 26

replacement therapy use of EC

Answer 26

for those with addison disease

Question 27

dental uses of EC

Answer 27

oral lesions, apthous stomatitis, TMJ pains, oral surgery, pulp procedures

Question 28

Oral corticosteroids are divided by their

Answer 28

duration of action: short acting, intermediate and long acting

Question 29

Oral corticosteroid products: short acting?Intermediate acting? Long acting?

Answer 29

S: hydrocortison, prednisone, methylprednisone
I: triamcinolone, prednisolone
L: dexamethasone, betamethasone

Question 30

antiinflammatory effects from short acting to long acting

Answer 30

decreases and dose decreases as well

Question 31

which OC is the standard

Answer 31

hydrocortisone

Question 32

corticosteroids suppress the immune response:

Answer 32

infections are more likely to occur, healing is delayed with chronic use, symptoms of infections may be masked, can make hypertension worse

Question 33

consideration with salicylates and NSAIDs

Answer 33

use with caution

Question 34

the preferred analgesic

Answer 34

acetaminphen or tylenol instead bc of GI effects of salicylates and NSAIDs

Question 35

what should be checked at each visit

Answer 35

BP and pulse, osteoporosis of the jaw and bone, perio

Question 36

be aware of

Answer 36

adrenal crisis