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PharmB > Corticosteroids > Flashcards

Corticosteroids Flashcards

1
Q

What are examples of systemic corticosteroids?

A
  • Prednisolone
  • Hydrocortisone
  • Dexamethasone
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2
Q

What are common indications for systemic corticosteroids?

A
  • Allergic or inflammatory disorders
  • Autoimmune disease
  • Cancer
  • Adrenal insufficiency
  • Hypopituitarism
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3
Q

What is the mechanism of action of systemic corticosteroids?

A

Bind to cytosolic receptors, which then translocate to the nucleus and bind to glucocorticoid response elements, which regulate gene expression. These genes include upregulation anti-inflammatory genes and down-regulation of pro-inflammatory genes (cytokines, TNFalpha). Other effects include monocyte depression, gluconeogenesis and stimulation of Na+ absorption and water retention, and K+ excretion

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4
Q
A
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5
Q

What are adverse effects of systemic glucocorticoid therapy?

A
  • Immunosuppression
  • Diabetes
  • Osteoporosis
  • Proximal muscle weakness
  • Skin thinning
  • Gastritis
  • Bruising
  • Psychosis
  • Confusion
  • Suicidal ideation
  • Hypertension
  • Hypokalaemia
  • Oedema
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6
Q

What are people at risk of with long term corticosteroid use if steroids are suddenly removed?

A

Addisonian crisis

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7
Q

What can corticosteroids increase the risk of if given with NSAIDs?

A

Peptic ulcers and GI bleeding

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8
Q

What can occur if systemic corticosteroids are given with B2-agonists/theophylline/loop diuretics/thiazide diuretics?

A

Hypokalaemia

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9
Q

What is the equivalent dose of prednisolone for 750mircograms of dexamethasone?

A

5mg

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10
Q

What is the equivalent dose of hydrocortisone for 750 micrograms of dexamethasone?

A

20mg

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11
Q

When should daily steroid therapy be prescribed?

A

In the morning - mimic circadian rhythm

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12
Q

What monitoring would you want to consider doing in long term glucocorticoid therapy?

A
  • Measure glucose and HbA1c
  • DEXA bone scan
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13
Q

What should you do when someone with long term steroid therapy is acutely unwell?

A

Double the dose - atrophic adrenal gland will not be able to produce adequate cortisol in response to stress

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14
Q

What is the equivalent dose of methylprednisolone for 750 micrograms of dexamethasone?

A

4mg

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15
Q

When are corticosteroids indicated for use?

A
  • Pregnancy
  • Breast Feeding
  • Diabetes
  • Heart failure
  • Peptic ulcers
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16
Q

What are the different methods of administration of steroids?

A
  • Oral
  • Rectal
  • SC
  • IV
  • Topical
  • intra-nasal
  • Inhalation
  • Intra-articular
17
Q

What would you want to give someone with long term corticosteroid therapy?

A

Steroid card and dont stop medication suddenly

18
Q

When you give high dose steroids for 3 weeks or more, what should you do when stopping therapy?

A

REducing regime

PharmB (29 decks)

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