Clinical Use of Steroids

Question 1

What are the two main types of steroids?

Answer 1

Glucocorticoids

Mineralocortocoids

Question 2

What are the four clinically common glucocorticoids?

Answer 2

Prednisolone (oral)
Beclometasone (inhaled)
Budenoside (asthma/GI)
Hydrocortisone/Cortisol (oral/topical/i.v.)

Question 3

What is the clinically most common mineralocortocoid?

Answer 3

Fludrocortisone

Question 4

What is the general MoA of steroids?

Answer 4

Act on intracellular receptors - alter gene transcription

Question 5

How long does it take for steroids to have their effect?

Answer 5

Several days

Question 6

What are the effects of Glucocorticoids?

Answer 6

Inhibit synthesis of COX-2 + NO synthase
Inhibit synthesis of cytokines + chemokines
Stimulate lipocortin production (inhibits PLA2)

Question 7

What are Glucocorticoids used for? - Anti-inflammatory/immunosuppressive

Answer 7

Allergic/septic emergency i.v.
Asthma/COPD
IBD
Rheumatoid Arthritis
Skin conditions
Organ transplantation
Rhinitis
Conjunctivitis

Question 8

What are Glucocorticoids used for? - Replacement therapy

Answer 8

Addison’s disease

Question 9

What are Glucocorticoids used for? - Others

Answer 9

Neoplastic disease

Pre-term labour

Question 10

What are the main ADRs of Glucocorticoids?

Answer 10

Diabetes
Osteoporosis
Mental disturbances
Peptic ulceration
Visual
Cushing's
Suppression of growth
Adrenal suppression
Infections

Question 11

How long does it take for the ADRs of Glucocorticoids to present?

Answer 11

> 3 weeks on oral therapy

Question 12

What are the effects of Mineralocorticoids?

Answer 12

Aldosterone type effects

• Na + water retention
• K loss
• Hypertension/CHF