Corticosteroids

Question 1

Deficiency of Corticosteroids cause

Answer 1

Addison’s disease

Question 2

Excess of Corticosteroids cause

Answer 2

Cushing’s disease

Question 3

Cortisone is

Answer 3

Cortisol and Aldosterone

Question 4

Release of cortisol causes

Answer 4

break down of bone osteoperosis
Protein catabolism
Lipolysis
Increase heart rate
Anti-inflammatory and is immunosuppressive
Stimulates synthesis of Annexin 1 which inhibits Phospholipase A2
Suppresses gene coding for IL2, COX 2

Question 5

Aldosterone causes

Answer 5

Incr. Renin and angiotensin
Hypokalemia: incr. K excretion
Incr. Na and H2O retention

Question 6

MOA

Answer 6

Release of HEAT protein
Activated receptor translocates to nucleus
=transcription=protein synthesis=steroid response
Stimulates release of

Question 7

Metabolic effects of corticosteroids

Answer 7

Incr. gluconeogenesis from amino acids
Promotes storage of glucose as glycogen
Inhibits protein synthesis
Induces protein catabolism
Inhibits peripheral glucose reuptake

Question 8

Catabolic and Anabolic effects of costicosteroids

Answer 8

Osteoporosis. osteonecrosis
Inhibition of growth in children
decr. muscle mass
weakness
thinning of skin

Question 9

CNS effects of Costicosteroids

Answer 9

Adrenal insufficiency
Incr. Glucoticoids cauce insomnia and euphoria floolowed by depression

Question 10

Chronic Addison’s symptoms

Answer 10

Weakness
Fatigue
Weight loss
Hypotension
Hyperpigmentation

Question 11

Drug for Chronic Addison’s

Answer 11

Hydrocortisone: 20-30g
Supplemented with Fludrocortisone: is a salt retaining steroid

Question 12

CI of Fludrocortisone

Answer 12

Acute psychosis
Occular herpes simplex

Question 13

DI of Fludrocortisone

Answer 13

Digoxin: hypokalemia risk
Phenotin, alcohol: decr. efficacy
Caution with Na retaing agents: NSAIDs

Question 14

AE of Fludrocortison

Answer 14

Dizziness
Headache
Hypertension
Cataracts
Na and H20 retention: weight gain, swelling of feet and ankles
Potassium depletion: weakness of limbs, fatigue, arrythmias

Question 15

TU of Hydrocortisone

Answer 15

fluid replacement therapy in patients with acute adrenal insufficiency
Allergy and inflammatory disorders
Hypersensitivity rxns: anaphylactic shock
Drug sensitivity
Status asthmaticus
Surgery prep for patients on long term glucocorticoid therapy
Topical: eczema
Enemas in ulcerative collitis

Question 16

Drug tx for Congenital adrenal hyperplasia

Answer 16

Hydrocortisone or Prednison
Fludrocortisone may be added to maintain BP, plasma renin-activity and electrolytes

Question 17

Symptoms of Aldosteronism

Answer 17

HT
weakness
tetany due to renal loss of K
Incr. plasma Na
Low levels of plasma renin and Ang 2

Question 18

Drug tx for Aldosteronsism

Answer 18

Fludrocortisone
Spironolactone (aldosterone antagonist)

Question 19

Hydrocortisone sodium succinate

Answer 19

ACute bronchospasm
Hypersensitivity rxn: anaphylactic shock
Drug sensitivity rxns

Question 20

Prednisolone/Prednisone

Answer 20

Inflammatory and allergic rxns

Question 21

Dexamethasone

Answer 21

Very potent
LOng acting, minimal slat retaining actions
-anaphylaxis
-cerebral oedma
- used for lung maturaion is NRDS
-combined with anti-emetics: n&v induced by chemo

Question 22

Betamethasone

Answer 22

Long DOA
-NRDS
-incr. intracranial pressure
-arthritis
-dermatitis

Question 23

Methylprednisolone

Answer 23

-asthma
-anaphylaxis
-rheumatoid arthritis
-used when mineral corticoid act. is undesirable

Question 24

Drugs of choice for asthma

Answer 24

Beclomethasone dipropionate
Budesonide
Ciclesonide mometasone
Fluticasone

Question 25

Drug of choice for inflammatory bowel syndrome

Answer 25

Budesonide

Question 26

Drug of choice for allergic rhinitis

Answer 26

Triamcinolone

Question 27

AEs of Corticosteroids

Answer 27

Hypertension Rounded, plethoric face (moon face) Hyperglycaemia Osteoporosis Hypokalemai Growth retardation in children Impotence Muscle wasting and weakness Adrenal suppression Can cause adrenal atrophy in therapy