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ENDOC > Corticosteriods > Flashcards

Corticosteriods Flashcards

1
Q

what are the two types of corticosteroids

A

-mineral corticosteroids
-glucosteriods

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2
Q

what does mineral corticosteroids do?

A

high fluid retention low anti-inflammatory effect

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3
Q

what does glucosteriods do

A

low fluid retention and high anti-inflammatory effect

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4
Q

mineral corticosteroid with most activity

A

fludrocortisone

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5
Q

mineral corticosteroid with second most activity

A

hydrocortisone

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6
Q

which mineralcorticoid is used as tx for postural hypotension

A

fludrocortisone

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7
Q

s/e of fludrocortisone

A

odema

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8
Q

s/e of mineralcorticoids

A

-sodium + water retention = hypertension
-k+ loss = hypokalaemia
-ca+ loss = hypocalcaemia

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9
Q

Which high potency glucorticoids are neligible with mineralcorticoid effects?

A

betamethasone and dexamethasone

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10
Q

highest glucocorticoid steroid activity?

A

dexamethasone
betamethasone

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11
Q

high glucocorticoid steroid activity?

A

prednisolone
prednisone
deflazacort

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12
Q

glucocorticoids s/e

A

-diabetes
-osteoporosis
-avascular necrosis of femoral head and muscle
wasting
-gastric ulceration and perforation

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13
Q

what is given alongside long-term steroid tx

A

PPI

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14
Q

most common corticosteroid s/e

A

CORTICOSTEROID USE
-cushing syndrome
-osteoporosis
-retardation of growth
-thin skin
-immunosuppression + insomnia
-chorioretinopathy
-oedema
-striae
-emotional disturbance
-rise in BP
-obesity
-increased hair growth (hirsutism)
-diabetes mellitus (hypogly)
-ulcers (peptic)
-suppression (adrenal)
-electrolyte imbalance (hypokal)

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15
Q

MHRA warning with corticosteroids

A

report blurred vision and visual disturbance

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16
Q

s/e of corticosteriod

symptoms of psychiatric reactions

A

STOP and SEEK help if:
-insomnia
-instability
-mood change
-suicidal thoughts
-behavioural disturbances

17
Q

how is adrenal supression caused with cortiocosteriod use?

A

-prolonged use can cause adrenal atropy (can last yrs even after tx finished)
-abrupt withdrawal can cause acute adrenal insufficiency, hypotension or death

18
Q

what can occur if there is an temporary increase in dose or temporary reintroduction if stopped?

A

significant illness
trauma
surgical procedure

19
Q

corticosteroid s.e

what is infections a cause of?

A

immunosupression
-serious infections may reach to advanced stage before being recognised

20
Q

cortiocosteriod s/e

common infections with cortiocosteriod

A

-chickenpox
-measles

21
Q

chickenpox as a s/e of corticosteroid

A

-risk of severe chickenpox unless pt has immunity
-vaccines needed for non-immune pt
-if confirmed needs specialist care and urgent tx

22
Q

s/e of corticosteroid

measles prophylaxis

A

-prophylaxis with IM normal immunoglobin PRN
-seek immediate medical advise if exposure occurs

23
Q

corticosteroid s/e

when to take dose to avoid insomnia

A

take dose in morning

24
Q

corticosteroid s/e

s/e in children

A

retardation of growth
-including oral and inhalation

25
Q

corticosteroid s/e

what route is thinning skin assoc with

A

topical

26
Q

corticosteroid s/e

cushing sydrome symptoms and tx

cushing= too much cortisol

A

-due to prolonged tx
-moonface, striae, hirustim and acne
-managed with metyrapone
-tx with ketoconazole

striae= stretch marks

27
Q

managing s/e of corticosteroids

A

-lowest effect dose for min period
-single dose morning
-if 2DY course = AD
-short courses
-local tx rather than systemic

28
Q

when corticosteroids gradual withdrawal

A

-40mg+ or equiv predn OD 1WK
-repeat evening doses
- >3wk tx
-recently repeated course
-taking short course within 1yr of stopping longterm therapy
-other causes of adrenal suppression

29
Q

topical steroid potency

A

-mild = hydrocortisone
-moderate = clobetasone
-potent = bethamethasone
-v.potent = clobetasol

30
Q

which diseases cause adrenal sufficiency?

A

addisons disease or congential adrenal hyperplasia

31
Q

adrenal insufficiency tx

A

hydrocortisone
-can also give fludrocortisone if primary insufficiency

32
Q

what can adrenal insufficiency lead to?

A

adrenal crisis

33
Q

adrenal insufficiency medical emergency tx

A

hydrocortisone

34
Q

symptoms of adrenal crisis

A

severe dehydration
hypokalaemia shock
altered consciousness
seizures
stroke
cardiac arrest

ENDOC (13 decks)

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