Corticosteroids Flashcards
What steroid has high mineraloorticoid activity but low glucocorticoid activity?
Fludrocortisone
Describe the glucocorticoid activity and mineralocorticoid activity of Hydrocortisone, Prednisolone and Dexamethasone
Hydrocortisone
- Some Glucocorticoid activity
- high mineralocorticoid activity
Prednisolone
- Predominant glucocorticoid activity
- Low mineralocorticoid activity
Dexamethasone
- Very high glucocorticoid activity
- minimal mineralocorticoid activity
what should happen to the dose of long-term steroids in a patient who has an intercurrent illness?
dose should be doubled
Why is it important not to stop long-term steroids abruptly
may precipitate an Addisonian crisis
Who should have a gradual withdrawal of steroids?
> 40mg prednisolone daily for >1 week
> 3 weeks of treatment
recently received repeated courses
Describe mineralocorticoid side effects
fluid retention
hypertension
Glucocorticoid endocrine side effects
impaired glucose regulation
weight gain
hirsutism
hyperlipidaemia
Cushing’s syndrome
Glucocorticoid MSK side effects
osteoporosis
proximal myopathy
AVN of femoral head
Glucocorticoid immunosuppresive side effects
Risk of severe infection
Reactivation of TB
Glucocorticoid psychiatric side effects
insomnia
mania
depression
psychosis
Glucocorticoid GI side effects
peptic ulceration
acute pancreatitis
Glucocorticoid ophthalmic side effects
glaucoma
cataracts
