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Pharm 3 > Anti-inflammatory Steroids > Flashcards

Anti-inflammatory Steroids Flashcards

1
Q

Where are steroids made?

A

Adrenal cortex

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2
Q

Which steroids are glucocorticoids?

A

Cortisol/hydrocortisone
Dexamethasone
Prednisolone

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3
Q

Which steroids are mineralocorticoids?

A

Aldosterone

Fludrocortisone

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4
Q

Which elements stimulate aldosterone synthesis?

A

Ang II and K

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5
Q

Which elements stimulate cortisol synthesis?

A

ACTH

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6
Q

Primary effects of glucocorticoids

A

Main effect is on carb and protein metabolism

Also anti-inflamm

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7
Q

Primary effect of mineralocorticoids?

A

Deal with water and electrolyte balance

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8
Q

3 mechanisms of neuroendocrine control of glucocorticoids

A
  1. Episodic secretion/circadian rhythm
  2. Stress responsiveness of HPA axis
  3. Feedback inhib by cortisol of ACTH secretion
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9
Q

Regulation of glucocorticoid synth by HPA axis

A 
Circadian/stressors 
Hypothalamus releases CRH
Anterior pituitary releases ACTH
(Bloodstream) adrenals release cortisol 
Neg feedback
(IL also stimulates cortisol which suppresses immune system)
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10
Q

Mechanism of glucocorticoids

A

Receptor inside cytosol
Dimerize and translocate to nucleus
Binds to GRE element which facilitates or decreases synth

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11
Q

Physiological actions of glucocorticoids

A

Metab: maintain glucose, redistribution of body fat (back of neck and face)
Break down: slows bone growth, muscle wasting, CNS alterations, dec secretion of growth hormone

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12
Q

Anti-inflamm/immunosuppressive actions of glucocorticoids

A

Inhibits monocytes and antigen presentation
Dec: cytokines, lymphocytes, prostaglandin, leukotriene

Dec COX2 and TNF
Inc annexin 1

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13
Q

How does aldosterone work?

A

Regulates ECF
Binds to renal cortical CD receptor
Translocates to nucleus and binds GRE/MRE to function as a transcription factor
Causes Na retaining via ENaC

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14
Q

How can mineralocorticoid receptors have specific action if they bind both glucocorticoids and mineralocorticoids equally?

A

Cortisol binds to MR at high affinity, but mineralocorticoid target tissues express 11B-HSD2 which presents glucocorticoids from interacting with the receptor (inactivates cortisol to cortisone)

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15
Q

Drugs given for fetal lung maturity

A

Hydrocortisone

Dexamethasone

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16
Q

Which steroid is used for replacement therapy?

A

Fludrocortisone - salt retaining!

17
Q

Dexamethasone suppression test

A

Test for hypercorticism
Dex suppresses production of ACTH, however if ACTH is high d/t an ectopic humor then dex will not me able to suppress the high level of ACTH

18
Q

2 forms of glucocorticoid toxicities

A

Abrupt w/d of drug: flare up of underlying dz, adrenal insufficiency, TAPER SLOWLY

Continued use of supraphysioloic doses for inflammation: growth suppression, susceptible to infection/TB, osteoporosis, Cushing’s

Pharm 3 (7 decks)

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