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Pre-pharmacology > Chapter 10 (corticosteroids and inflammation) > Flashcards

Chapter 10 (corticosteroids and inflammation) Flashcards

1
Q

inflammation

A

served a protective function in body and helps us heal, but also causes pain and swelling

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2
Q

increased blood flow to damaged areas is helpful at the start…

A

but then we want relief from it because of the pain

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3
Q

corticosteroids were first helpful therapies for diseases like…

A

RA (rheumatoid arthritis), lupus, severe dermatitis, Crohn’s disease, asthma, anaphylaxis, food allergies, etc.

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4
Q

to treat inflammation, normally all that is needed is…

A

NSAIDs, ice, and immobilization

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5
Q

inflammation left unabated…

A

causes damage to areas inflammed like joints; chronic inflammation in body has been linked to heart disease

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6
Q

corticosteroids

A

groups of steroidal hormones all derived from cholesterol

Naturally occuring corticosteroid is cortisol, which is produced in the adrenal glands on top of the kidney

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7
Q

cortisol functions

A

modulate glucose levels and body responses to stress; temper the immune function and thereby decrease the inflammatory response; helps us stay awake but then we crash

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8
Q

cholesterol template produced what endogenous substances?

A

sex steroids (male=testosterone, dihydrotestosterone) (female=estradiol and others), mineralocoritcoids (regulate salt levels in body), and cortisol

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9
Q

Cushing syndrome

A

when people are taking prednisome for long periods of time; looks same as Cushing disease, people look cushinoid

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10
Q

Cushing disease

A

too much endogenous cortisol produced by adrenal glands, usually result of tumor in adrenal gland; people look cushinoid

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11
Q

eicosanoids

A

local hormones derived from the AA cascade that act locally at the tissue level to cause pain and inflammation among other things like regulating BP

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12
Q

molecules that make up eicosanoids

A

prostaglandins (PGs), thromboxanes (TXAs), and leukotrienes (LTs)

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13
Q

corticosteroid mechanism

A

inhibit the arachidonic acid cascade to a much greater degree than NSAIDs and that is why they are much better at stopping inflammation; but explains their side e’s
Block formation of AA so all eicosanoids (PGs, TXAs, and LTs) do not form

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14
Q

corticosteroid antiinflammatory action compared to NSAIDs

A

better antiinflammatory action in corticosteroids because they inhibit all aspects of the arachidonic acid cascade (they block the formation of AA)

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15
Q

Singlulair

A

montelukast; leukotriene inhibitor

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16
Q

NSAIDs like ibuprofen

A

inhibit COX1 (blocks turning AA into those PGs and TXAs made by COX1)

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17
Q

COX2 inhibitors like Celebrex

A

inhibit COX2 (blocks turning AA into those PGs and TXAs made by COX2)

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18
Q

leukotriene receptor blockers like Singlulair

A

inhibit lipoxegenase (blocks turning AA into LTs made by lipoxegenase)

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19
Q

hydrocortisone

A

cortisol-like drug synthesized as medicine

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20
Q

short-term effects of corticosteroids

A

pts. feel very good, often insomnia but pts. don’t mind b/c there is increased energy

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21
Q

long-term effects of corticosteroids

A

characteristic body habitus (body shape) and the person is said to be cushinoid;
Fat on shoulders, abdomen, and face (moon face), muscle loss on limbs, edema, easy bruising, increase cancer risk, hirsutism (hairyness), purple striae (red lines and stretch marks), immune suppression and poor wound healing, hypertension, fatigue, depression, truncal obesity

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22
Q

to avoid systemic corticosteroid effects…

A

corticosteroids are used regionally or locally to reduce effects; use drugs that are intentionally built to be poorly absorbed

23
Q

systemic use corticosteroids

A

oral prednisone, IM Kenalog (triamcinolone), IV Solu-Medrol (methylprednisolone)

24
Q

oral prednisone

A

moderately potent systemic corticosteroid

25
Q

Kenalog

A

triamcinolone; systemic corticosteroid, IM “allergy shot” (incorrectly called “cortisone shot”) to reverse very severe allergies. Can only be in cream, nasal spray, pill, or other injection

26
Q

Solu-Medrol

A

methylprednisolone; systemic corticosteroid, IV used to treat emergency anaphylactic reaction

27
Q

allergy shot (not Kenalog)

A

small, increasing doses of allergen injected to produce “blocking antibodies”
Part of immune therapy and takes 2-3 years to complete therapy

28
Q

sex steroids

A

non-inflammatory steroids that are produced by the adrenal gland in small amounts, but in adults the majority of the hormones come from testes or ovaries
Responsible for sexual sex characteristics and libido

29
Q

corticosteroids

A

body secretes in times of stress; drugs given for antiinflammatory effects

30
Q

gonads

A

only steroids secreted are sex steroids

31
Q

adrenal gland in women

A

important for creating androgens for women so they have lobido

32
Q

DHT

A

dihydrotestosterone

33
Q

most imporant male androgen hormones

A

testosterone and DHT

34
Q

most important female estrogen hormone

A

estradiol (E2); predominant estrogen of non-pregnant women which is produced primarily by developing ovarian follicles
Some estrogens are also produced in smaller amounts in the liver, adrenal glands, and breasts

35
Q

all male sex steroids have anabolic properties

A

they build up cellular tissue, especially muscle

36
Q

AAS

A

anabolic androgen steroids; first used by soviet union in olympics in early 1970s
All schedule 3 drugs b/c of high abuse rates
Sometimes given to AIDS patients to help them gain weight

37
Q

long term AAS effects

A

aggressive behavior, decreased sperm count, shrunken testes, baldness, and hirsutism (hairyness)

38
Q

Dianabol

A

methandrostenolone; first anabolic steroid in US, developed for olympic athletes; AAS with action similar to testosterone

39
Q

r-hGH

A

recombinant human Growth Hormone

40
Q

HGH

A

human growth hormone; produced in pituitary gland to mediate normal growth
Spurt in adolescence seen with growth spurt

41
Q

Genotropin

A

first recombinant HGH produced and used as medicine

42
Q

hGH was developed as replacement for children not growing properly, from either…

A

pituitary dwarfism or Growth Hormone Deficiency in children

43
Q

hGH abuse

A

abused to stimulate muscle growth, lose fat, and increase glucose output from liver
Very dangerous b/c adults have fused growth plates but still tell bones to grow so calcification occurs

44
Q

expansion issues from hGH abuse

A

jaw expansion so mouth can’t open much and tongue expands which blocks airway, frontal bossing (prominent forehead), and enlargement of nose pores and mandible occlusion

45
Q

hGH abuse effects mimics…

A

acromegaly; a hormonal disorder that develops when your pituitary gland produces too much growth hormone during adulthood. When this happens, your bones increase in size, including those of your hands, feet and face.

46
Q

cortisone

A

synthetic derivative of cortisol

47
Q

hydrocortisone

A

found in diluted concentrations in OTC creams; waste of money b/c they are too weak and aloe vera works better
Also formulated in Rx strength as enema (Cortenema) for use in Crohn’s disease and Ulcerative Colitis

48
Q

Cortenema

A

Rx strength enema hydrocortisone for Crohn’s disease and Ulcerative Colitis

49
Q

prednisone

A

one of the most popular, potent corticosteroids. Usually given orally

50
Q

Kenalog

A

triamcinolone; popular Rx strength cream and ointment

51
Q

betamethasone

A

popular Rx strength cream and ointment

52
Q

anabolic androgen steroids

A

testosterone, DHT (dihydrotestosterone), Dianabol

53
Q

synthetic corticosteroids are modeled after…

A

the natural hormone coritsol found in the adrenal cortex

Pre-pharmacology (27 decks)

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