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Pharm > Corticoids > Flashcards

Corticoids Flashcards

1
Q

What are corticoids? (2)

A
  • steroid hormones

- synthesized in the adrenal cortex

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2
Q

Steroids are a derivative of…?

A

cholesterol

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3
Q

What steroid is produced in the ovaries? (2)

A

estrogen + progesterone

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4
Q

What steroid is produced in the testicles

A

androgens

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5
Q

What steroid is produced in the adrenal glands?

A

corticoids

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6
Q

What is the mineralocorticoid?

A

aldosterone

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7
Q

What is the function of aldosterone?

A 
electrolyte metabolism (reabsportion)
ex. water, sodium
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8
Q

What is the glucocorticoid hormone?

A

CORTISOL-HYDROCORTISONE

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9
Q

What is the function of cortisol? (4)

A

intermediate metabolism

  • gluconeogenesis
  • lipolysis
  • proteolysis
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10
Q

What is the androgenic steroid?

A

androsterone

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11
Q

What is the function of androsterone?

A

virilizing effect (development of male characterisitics)

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12
Q

Describe the hypothalamic-pituitary-adrenal axis (3)

A

hypothalamus –> hypophysis –> adrenal glands

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13
Q

Describe the hypothalamic-pituitary-adrenal axis’s hormones (4)

A

CRH –> ACTH –> cortisol

Each hormone produced has a negative feedback on the one that produced it

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14
Q

What main matabolism effects do glucocoticoids have? (3)

A
  • release of glucose

- decreased formation of proteins and fats

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15
Q

What are the other roles of glucocorticoids? (5)

A
  • adaptation to stress
  • anti-inflam.
  • suppress immune system
  • maintaining blood pressure
  • bone density
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16
Q

Do steroids have more side effects than NSAIDs?

A

yes

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17
Q

Are steroids a more potent anti-inflam than NSAIDs?

A

yes

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18
Q

Are corticoid drugs natural or synthetic?

A

both

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19
Q

What is the advantage of synthetic corticoids? (3)

A
  • metabolized slower in the liver
  • therefore longer halflife
  • more potent
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20
Q

Rank the glucocorticoids in order of highest potency (4)

A
  • dexamethasone
  • methylprednisolone
  • prednisone
  • cortisol
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21
Q

equivalent doses become ____ as the potency increases

A

smaller

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22
Q

equivalent doses for corticoids use which drug as a reference?

A

cortisol - activity = 1

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23
Q

What is the mechanism of action for corticoids?

A

-inhibition of phospholypase A2

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24
Q

glucocorticoids effects? (3)

A
  • anti-inflam
  • immunosupressive
  • inhibition effect of lymphoid tissue
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25
Q

Glucocorticoid mechanism of action?

A

phospholipase A2 inhibition

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26
Q

route of administration for glucocorticoids? (6)

A
  • oral
  • IV
  • IM
  • topical
  • inhaled
  • SC
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27
Q

What is the immunosuppresive effect with glucocorticoids? (2)

A
  • medium dose: prevent antigen-Ab binding stopping release of mediators and cell damage
  • High dose: reduces synthesis of Ab and antigen-Ab binding
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28
Q

What is the inhibition effect of lymphoid tissues with glucocorticoids?

A
  • decreased clonal expansion of T&B cells

- decreased action of T cells secreting cytokines

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29
Q

What are the 2 main glucocorticoid indications?

A
  • endocrine replacement therapy

- non endocrine diseases

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30
Q

Why are glucocorticoids used for endocrine replacement therapy?

A

Addison’s disease

31
Q

Why are glucocorticoids used for non-endocrine diseases? (6)

A

anti-inflam:

  • rheumatic diseases
  • idiopathic inflam diseases
  • allergies(asthma, insect bites, urticaria)

Immunosuppressive

  • autoimmune
  • organ transplant (avoid rejection)

Neoplastic disease

  • in combo with cytotoxic drugs to treat specific malignancies
    ex. acute lymphocytic leukemia, hodkin’s
32
Q

What types of allergies do glucocorticoids treat? (3)

A
  • asthma
  • insect bites
  • urticaria
33
Q

What are glucocorticoids immunosuppressive effects used for? (2)

A
  • auto-imune diseases

- organ transplant (avoids rejection)

34
Q

How are glucocorticoids used with neoplastic diseases? which? (3)

A
  • in combo with cytotoxic drugs to treat specific malignancies
    ex. acute lymphocytic leukemia, hodkin’s
35
Q

What is the glucocorticoid route of administration for rheumatic diseases?

A

oral

36
Q

What are the rheumatic diseases? (2)

A
  • rheumatoid arthiritis
  • ankylosing spondylitis
  • other severe acute arthritis
37
Q

How do we treat ankylosing spondylitis? (2)

A
  • glucocorticoids are second choice

- use for shortest time and lowest possibile dose

38
Q

What class of drugs treat bronchial asthma? whats the route of administration? (3)

A
  • glucocorticoids
  • inhaled
  • IV
39
Q

What drugs do we use for bronchial asthma? (4)

A
  • Budesonide
  • beclomethasone
  • fluticasone
  • IV glucocorticoids
40
Q

When do we use IV glucocorticoids? (2)

A
  • bronchial asthma (asthmatic crisis)

- digestive inflammatory diseases

41
Q

When do we use IV glucocorticoids for bronchial asthma

A

during asthmatic crisis

-has side effects

42
Q

What is the glucocorticoid route of administration for digestive inflam. diseases? (3)

A
  • oral
  • IV
  • enema
43
Q

What glucocorticoid is used for digestive inflam. diseases?

A

budesonide

44
Q

What is the glucocorticoid route of administration for ocular inflammatory diseases?

A

topical

45
Q

What ocular inflammatory diseases do we use glucocorticoids for? (3)

A
  • allergic conjunctivitis
  • scleritis
  • uveitis
46
Q

What is the glucocorticoid route of administration for skin diseases?(2)

A
  • topical

- general

47
Q

What skin diseases do we use glucocorticoids for? (3)

A
  • eczema
  • psoriasis
  • pemphigus
48
Q

What allergic diseases do we use glucocorticoids for? (2)

A
  • anaphylaxis

- serum sickness

49
Q

What autoimmune diseases do we use glucocorticoids for? (3)

A
  • lupus erthematosus
  • scleroderma
  • vasculitis
50
Q

Which glucocorticoids are used to treat leukemia and lymphoma? (2)

A
  • prednisolone

- deamethasone

51
Q

What are the routes of administration for glucocorticoids locally (4)

A
  • topic
  • inhaled
  • subcutaneous
  • intraarticular
52
Q

What are the routes of administration for glucocorticoids systemic (4)

A
  • ORALLY
  • INTRAMUSCULAR (irregular bioavailability) -INTRAVENOUS
  • RECTAL (enemas)
53
Q

Which glucocorticoids are used orally?

A
  • Prednisone - intermediate action

- Deflazacort - intermediate -Prednisolone

54
Q

Steroids in dentistry used for: (8)

A 
Stomatitis
  Lichen planus
  Desquamative gingivitis
  Cheilitis (inflammation of the lips)
  Traumatic ulcer
  Pulpitis
  Temporomandibular joint pain
  Systemic disease oral lesions
55
Q

Steroid contraindications in dentistry?

A

herpetic sores

56
Q

Topical steroid contraindications?

A

skin infections

57
Q

Which topical steroid do we use first?

A

-hydrocortisone

58
Q

Glucocorticoid contraindications? (3)

A

Gastroduodenal ulcer
Osteoporosis
Psychosis

59
Q

What are the adverse reactions with glucocorticoids and mineralocorticoids? (5)

A
  • cortisol, prednisone and prednisolone produce mineralocorticoid effect
  • Na+ and water retention by the kidney.

Results in:

  • weight gain
  • oedema
  • hypertension
60
Q

What are the adverse reactions with glucocorticoids mentally? (5)

A
  • Moderate euphoria, feeling of well-being
  • Insomnia
  • depression
  • memory impairment
  • Acute psychosis
61
Q

What are the adverse reactions with glucocorticoids and eyes? (3)

A
  • cataracts
  • intraocular hypertension
  • glaucoma (genetically predisposed)
62
Q

What are the adverse reactions with glucocorticoids and hormonal changes? (3)

A
  • inhibition of growth >6months in children

- women: menstrual disorders + amenorrhea

63
Q

What are the adverse reactions with glucocorticoids and digestion? (2)

A
  • alters gastric mucoa causing gastritis or peptic ulcer

- acute pancreatitis

64
Q

What adverse effect happens with postmenopausal women and glucocorticoids?

A

loss of bone mass

65
Q

What are the adverse reactions with glucocorticoids and bones? (2)

A
  • loss of bone mass

- happens more in postmenopausal women

66
Q

What are the adverse reactions with glucocorticoids and muscles? (2)

A
  • loss of strength

- weakness/atrophy

67
Q

What is the iatrogenic adverse reactions with glucocorticoids

A

cushings disease

68
Q

What are the adverse reactions with glucocorticoids and adrenal cortex? (2)

A
  • hyperglycemia: steroid diabetes

- hyperlipidemia

69
Q

What are the adverse reactions with glucocorticoids and adrenal cortex? (2)

A
  • atrophy

- supression/inhibition of hypothalamic-pituitary-adrenal axis

70
Q

What are the irreversible side effects of glucocorticoids? (3)

A
  • osteoporosis
  • in children- inhibition of growth
  • eye disorders - cataracts
71
Q

Most adverse effects for glucocorticoids… (2)

A

disappear after months or years of stopping treatment.

*some are irreversible

72
Q

Describe adverse reactions with glucocorticoids treatment duration (2)

A
  • short treatments (<15 days): none

- long treatments (>2months): appear with doses above 5-10 mg prednisone/day

73
Q

To maintain disease control, glucocorticoid treatment starts off….

A

high dose (ex. prednisone) and decreased slowly until lowest dose

Pharm (14 decks)

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