Analgesics and Anti-inflammatories - Steroids (1)

Question 1

Which compound do steroids inhibit?

Answer 1

Phospholipase. This prevents the conversion of membrane phospholipids into arachidonic acid, and thereby prevents the production of arachidonic acid metabolites such as leukotrienes and prostaglandins.

Question 2

What is the difference between cortisol and hydrocortisone?

Answer 2

Hydrocortisone is the pharmaceutical preparation of cortisol. Cortisol is a naturally-occurring hormone.

Question 3

From which compound is cortisol synthesized?

Answer 3

Cholesterol (just like the androgens and the mineralocorticoids)

Question 4

How much of cortisol is excreted unchanged in urine?

Answer 4

Only 1%.

Question 5

Give an overview of how steroids inhibit inflammation.

Answer 5

• Multiple inhibitory effects on the recruitment and function of leukocytes
• Reduction of leukotriene, platelet-activating factor and prostaglandin synthesis.

Question 6

Name a drug with mineralocorticoid action given orally.

Answer 6

Fludrocortisone.

Question 7

Name two long-acting glucocorticoid drugs.

Answer 7

Dexamethasone, Betamethasone.

Question 8

Name as many adverse effects of long-term steroid use as you can.

Answer 8

Moon facies, hirsutism, acne, insomnia, increased appetite, hyperglycaemia, weight gain, muscle wasting, thinning of the skin, striae, bruising, osteoporosis, impaired wound healing, peptic ulcers.