Chapter 6 BNF (Corticosteroid responsive conditions) Flashcards
What’s the function of mineralcorticoids?
Fluid retention
What steroids have the most mineralcorticoid effects?
Fludrocortisone
Hydrocortisone (significant so should not be used long term)
How do mineralcorticoids affect electrolytes?
Sodium retention
Potassium and calcium loss
What do glucocorticoids do?
Anti inflammatory
What steroids have the most potent glucocorticoid action?
Betamethasone / Dexamethasone
Prednisolone (significant)
What are the glucocorticoid side effects?
Diabetes Osteoporosis Ulcers /irritation Psychiatric reactions Infections Adrenal suppression
When should prophylaxis with bisphosphonates be introduced to steroid patients?
> 3 months
What should be avoided by patients on long term steroids?
Measles
Chicken pox / Shingles
What are the effects of adrenal suppression?
Sodium and water loss
Potassium and calcium retention
Hypoglycaemia
When should abrupt withdrawal be avoided with steroids?
> 3 weeks
Prednisolone 40 > 1 week
Evening doses
Short course within 1 years of long one
How do steroids affect pregnancy?
Generally safe: monitor fluid retention
What steroids are used in Adrenalectomy and Addisons Disease?
Hydrocortisone
Fludrocortsone
What steroids are deficient in adrenalectomy and Addison’s disease?
Cortisol (glucocorticoid)
Aldosterone (mineralcorticoid)
What steroids are used in hypopituitarism?
Hydrocortisone alone
RAAS still functional
What are the symptoms of Cushing syndromes ?
Skin thinning
Moon face
Acne
Amenorrhoea
