Ch. 76- Glucocorticoids Flashcards
What are glucocorticoid drugs nearly identical to?
Steroids produced by the adrenal cortex
What are the physiological effects of glucocorticoids at low doses?
Modulation of glucose metabolism in adrenocortical insufficiency
What are the pharmacologic effects of glucocorticoids at high doses?
Suppression of inflammation
Where are glucocorticoid receptors located?
Inside the cell
What do glucocorticoids modulate in comparison to other drugs?
Production of regulatory proteins vs. signaling pathways
What is one effect of glucocorticoids on metabolism?
Increase in glucose levels
What happens to protein synthesis under the influence of glucocorticoids?
Suppressed protein synthesis
What is a consequence of glucocorticoid treatment regarding fat deposits?
Fat deposits are mobilized
What electrolyte disturbances can glucocorticoids cause?
Sodium retention and potassium loss
What effect do glucocorticoids have on calcium absorption?
Inhibits intestinal absorption of calcium
List three therapeutic uses of glucocorticoids in nonendocrine disorders.
- Rheumatoid arthritis
- Systemic lupus erythematosus
- Inflammatory bowel disease
What is a significant adverse effect of glucocorticoids?
Adrenal insufficiency
What is a common psychological disturbance associated with glucocorticoid use?
Psychologic disturbances
What should be monitored due to glucocorticoid use?
Signs of insufficiency during tapering
What is a key precaution when using glucocorticoids?
Use with caution in pediatric patients and in women who are pregnant or breast-feeding
What are two contraindications for glucocorticoid use?
- Patients with systemic fungal infections
- Those receiving live virus vaccines
What is the recommended approach for glucocorticoid withdrawal?
Taper the dosage over 7 days
What routes of administration are available for glucocorticoids?
- Oral
- Parenteral (IV, IM, subQ)
- Topical
What factors determine glucocorticoid dosage?
- Biologic half-life
- Mineralocorticoid potency
- Glucocorticoid potency
What should be done with glucocorticoid doses in times of stress?
Increase the dosage
What is the purpose of alternate-day therapy with glucocorticoids?
Reduces adrenal suppression and toxicity overall
What is the most important monitoring aspect for a patient on prednisone for systemic lupus erythematosus?
Monitor for hypoglycemia
What should a patient prescribed pharmacologic doses of glucocorticoids be taught?
Never abruptly withdraw therapy
Which manifestation is NOT expected in a patient with Cushing’s syndrome?
Hypoglycemia
