corticosteroids

Question 1

what are the 2 groups of corticosteroid

Answer 1

glucocorticoid and mineralocorticoid

Question 2

what are glucocorticoids function

Answer 2

has peripheral actions on metabolism, anti inflammatory and immunosuppressive function

Question 3

aldosterone is what ind of corticosteroid? What is its function

Answer 3

it is a mineralocorticoid, regulates Na+ and H2O metabolism.

aldosterone bind mineralocorticoid receptor and upregulate basolateral Na+/K+ ATPase gene exprssion

Question 4

In excess of of aldosterone, what does it lead to

Answer 4

hypokalemia, hypernatraemia, metabolic alkalosis, oedema

Question 5

What is an example of a mineralocorticoid synthetic analogue

Answer 5

fludrocortisone

Question 6

What is fludrocortisone used to treat

Answer 6

addison disease, salt losing adrenogenital syndrome

Question 7

What kind of corticosteroid is cortisol

Answer 7

glucocorticoid

Question 8

what are the metabolic effects of cortisol

Answer 8

• increase gluconeogenesis
• decrease peripheral glucose uptake
• increase lipolysis and lipogenesis ( fat redistribution)
• increase glycogen deposition
• has some form of mineralocorticoid activity

Question 9

What are some catabolic effect of cortisol

Answer 9

1 increase risk of osteoporosis
2. catabolic effect on proteins in lymphoid, muscle, skin, bone connective tissue
3. negative nitrogen and calcium balance

Question 10

What does cortisol feedback inhibition do

Answer 10

decrease acth secretion due to it inhibiting the hypothalamus

Question 11

How does cortisol increase the risk of COPD and asthma

Answer 11

increases surfactant production in lungs

Question 12

how does corticosteroids have its inflammatory actions

Answer 12

decreases pro inflammatory genes

increase expression of anti-inflammatory genes

Question 13

What are some examples of pro inflammatory genes

Answer 13

• cytokines–> TNFa, IL2, IFNy
  -Chemokines–> rantes
• inflammatory enzymes–> cox 2, 5 LOX, phospholipase A2, much broader action than NSAIDS
• adhesion molecules that is important for the migration and motility of inflammatory/ immune response cells like ICAM-1, VCAM-1
• Receptors –> IL2R, T cell receptor

Question 14

what are some examples of anti inflammatory genes

Answer 14

endonuclease
annexin a1
IL1 receptor antagonist
IL1R2 ( decoy receptor)
neutral endopeptidase
MAPK Phosphatase 1
B2 adrenoceptor

Question 15

What are the 6 drugs of corticosteroids that we need to know

Answer 15

hydrocortisone
prednisolone
methylprednisolone
triamcinolone
betamethasone
dexamethasone

Question 16

What are the principles of corticosteroid therapy

Answer 16

1. host response are the cause of symptoms
2. steroid usually not curative
3. standard choice is short acting steroid with little salt retaining activity
4. at lowest possible dose to achieve desired effect
5. do not stop therapy abruptly
6. Use pulse therapy

Question 17

What are some side efefcts of corticosteroids

Answer 17

• euphoria
• hyperglycemia
• moon face
  -muscle wasting
• growth retardation in pediatric patients
• acne hirutism, menstrual disturbance
• delayed wound healing
• skin thinning
• odema, hypertension, chronic heart failure

Question 18

what are the side effects of corticosteroids on the musculoskeletal ystem

Answer 18

• osetoporosis, aseptic necrosis of femoral head, myopathy ( by triamcinolone and dexamethasone)

Question 19

What are some side effects of corticosteroids on the eye

Answer 19

posterior subcapsular lens cataract, glaucoma