Anti-inflammatory drugs

Question 1

use of non steroidal anti inflammatory drugs

Answer 1

mild-mod inflammation
needs to be taken continuously

Question 2

use of steroidal anti inflammatory drugs

Answer 2

powerful anti inflammatory/immunosuppressive effects
consists of glucocorticoids

Question 3

What are steroidal anti inflammatory drugs made of?

Answer 3

glucocorticoid activity
made from cholesterol, 4 ring structure

Question 4

glucocorticoid basic MOA

Answer 4

shut down inflammatory response by immunosuppression

Question 5

endogenous adrenocorticosteroids

Answer 5

cortisol
corticosterone
aldosterone
sex hormones

Question 6

functions of glucocorticoids

Answer 6

control GLC metabolism
control body ability to deal w stress
decrease inflammation
suppress immune system

Question 7

steroid synthesis

Answer 7

cholesterol is precursor w 4 ring chain
different side groups

Question 8

specific glucocorticoid MOA

Answer 8

act on inflammatory cells binding glucocorticoid receptors in cytoplasm
complex travels to nucleus altering gene expression to decrease inflammatory cytokine expression and increase antiinflammatory protein expression

Question 9

clinical use of glucocorticoids (conditions)

Answer 9

endocrine: normalize adrenal cortical hypofunction
diagnostic to evaluate hormonal disorders
nonendocrine: antiinflammatory or immunosuppressive for RA, myositis, tenosynovitis, collagen disease, OA
injections: carpal tunnel

Question 10

common glucocorticoids

Answer 10

betamethasone (celestone)
Methylprednisolone (Medrol)
Cortisone (Cortone acetate)
Prednisolone (Prelone)
Dexamethasone (Decadron)
Prednisone (Deltasone)
Hydrocortisone (Cortef)
Triamcinolone (Aristocort)

Question 11

glucocorticoid suffix

Answer 11

-sone

Question 12

glucocorticoid administration methods

Answer 12

oral: maintenance dose for RA/autoimmune
injection: local, 3-4 max per year
topical
nasal
opthalamic
otis

Question 13

adverse effects of glucocorticoids

Answer 13

• Adrenocortical suppression
• Peptic Ulcers
• Drug-Induced Cushing Syndrome
• Adrenal crisis/ shock
• Breakdown of supporting tissues
• Decreases body’s ability to
  absorb calcium and can lead to:
• Osteoporosis
• Delayed wound healing

Question 14

side effects of glucocorticoids

Answer 14

●Headache
●Irregular heartbeat
●Sweating
●Dizziness
●Irritability

Question 15

how does a glucocorticoid cause connective tissue breakdown?

Answer 15

wasting effect from prolonged use
inhibition of genes responsible for collagen production, increase expression of substances promoting breakdown
interfere with muscle protein synthesis
skeletal muscle atrophy

Question 16

drug induced cushing syndrome

Answer 16

results in:
roundness
trunk obesity
muscle wasting
HTN
osteoporosis
increased body hair
GLC intolerance

Question 17

adrenal shock

Answer 17

prolonged use of glucocorticoids cause adrenocortical suppression
if they are suddenly discontinued, body can go into shock
vasodilation, vascular collapse, severe hypotension
s/s: leg, LBP, abdominal pain; low BP; syncope; hyperkalemia; hyponatremia; vomit/diarrhea

Question 18

osteoporosis from glucocorticoids

Answer 18

they shift balance of bone metabolism increasing breakdown by stimulating osteoclasts and inhibit osteoblasts

Question 19

PT implications of osteoporosis drugs

Answer 19

increased of falls, fxs, infection
need strengthening to maintain muscle mass
WB activity best
assess skin breakdown
monitor BP