Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology Exam 5 > Corticosteroids > Flashcards

Corticosteroids Flashcards

1
Q

Where are corticosteroids synthesized and stored and what are they made with?

A

adrenal cortex, cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the two types of corticosteroids?

A

glucocorticoids, mineralocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which is the primary example of glucocorticoid?

A

Cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which is the primary example of mineralocorticoid?

A

Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does Aldosterone do?

A

Na retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What effects does Cortisol have (3)?

A

metabolism, anti-inflammatory, immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Do Mineralocorticoids have any effect on glucocorticoid receptors?

A

No!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Do glucocorticoids have affinity for mineralocorticoid receptor?

A

Yes! cross-reactivity (side effects)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hypothalamic-Pituitary-Adrenal (HPA) Axis: what hormone is released from hypothalamus?

A

Corticotropin releasing hormone (CRH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

HPA axis: Which hormone is released from anterior pituitary?

A

Adrenocorticotropic hormone (ACTH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

HPA axis: Which hormone is released from adrenal cortex?

A

Cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the regulatory mechanism of cortisol release?

A

negative feedback by cortisol at hypothalamus AND anterior pituitary (increases of cortisol is due to decreased negative feedback!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is an example of a hypo-secretion pathology (cortisol)?

A

Addisons Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is an example of a hyper-secretion (cortisol) pathology?

A

Cushings Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the corticosteroids to know (7)?

A

hydrocortisone, Prednisone, Triamcinolone, Dexamethasone, Betamethasone, Fluticasone, Fluocinonide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which corticosteroid is a prodrug?

A

prednisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which corticosteroid is inhaled?

A

Fluticasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which corticosteroid is topical?

A

fluocinonide

19
Q

Which corticosteroid is actually cortisol?

A

hydrocortisone

20
Q

What are the physiological actions of cortisol (5)?

A

1) activated gluconeogenesis and hyperglycemia (increase liver production of glucose)
2) activates catabolism of protein and lipids (permissive) (increase amino acids for gluconeogenesis)
3) maintains blood volume (activated mineralocorticoid receptors, just like aldosterone)
4) maintains vascular function (blood pressure) (enhance effect of catecholamines)
5) anti-inflammatory/immunosuppression (higher doses)

21
Q

What are the “activation” effects of glucocorticoids?

A

increase: gluconeogenesis genes, protein catabolism genes, and lipid catabolism genes…metabolism genes

22
Q

What are the “repression” effects of glucocorticoid?

A

decrease: prostaglandins, leukotrienes, cytokines…inflammatory-response genes

23
Q

What are 2 effects of corticosteroids on immune cells?

A

1) inhibition of migration from vascular space to site of injury (decrease endothelial intracellular adhesion molecules for leukocyte localization)
2) inhibition of phospholipase A2 and cycooxygenase-2 (decrease prostaglandins and leukotrienes)

24
Q

What is effect of corticosteroids on mast cells and basophils?

A

decrease histamine release

25
Q

What is effect of corticosteroids on monocytes and macrophages (3)?

A

decrease production of proinflammatory cytikines, decrease chemotaxis response, decrease differentiation into macrophages

26
Q

What is effect of corticosteroids on lymphocytes (3)?

A

decrease T cell response to antigens, mitogens, decrease proliferation, decrease proinflammatory cytokine gene expression

27
Q

What is the net effect of corticosteroids?

A

immunosuppression, anti-inflammatory, decreased pain and tissue destruction

28
Q

Are the anti-inflammatory effects of corticosteroids curative or palliative?

A

Palliative!

29
Q

What is the short-acting corticosteroid?

A

hydrocortisone

30
Q

What are the intermediate acting corticosteroids?

A

prednisone, triamcinolone

31
Q

What are the long acting corticosteroids?

A

dexamethasone, betamethasone

32
Q

Which ones don’t cause any Na retention?

A

Triamcinolone, Dexamethasone, Betametasone

33
Q

What are the two other corticosteroids and what’s unique about them?

A

Fluticasone (inhaled, reduced systemic effects), Fluocinonide (topical)

34
Q

What is the toxicity of corticosteroids with continued use?

A

Iatrogenic Cushing’s Disease

35
Q

What are the toxicities of chronic use of corticosteroids (Iatrogenic Cushing’s Disease) (8)?

A

hypertension (mineralocorticoid receptors and vasoconstriction), hyperglycemia (diabetes), susceptibility to infection/poor wound healing, osteoporosis (calcium loss), muscle myopathy/weakness, GI ulcers (NSAIDs), cataracts, psychosis

36
Q

What does withdrawal of corticosteroids cause?

A

iatrogenic adrenal insufficiency

37
Q

What are the characteristics of iatrogenic adrenal insufficiency?

A

adrenal-pituitary suppression due to feedback inhibition and adrenal atrophy…therefore suppresses normal response to stress. (ACTH and Cortisol release inhibited by prednisone)

38
Q

What are the symptoms of iatrogenic adrenal insufficiency? how long to restore hormone levels?

A

decreased response to stress: nausea, fatigue, weight loss, hypotension, shock. may require 2-6 months to restore normal ACTH/cortisol production

39
Q

What are the two dosage schedules for systemic oral corticosteroids?

A

Tapering dose, alternate day therapy

40
Q

What are the characteristics of tapering dose schedule (3)?

A

gradual reduction in dose over 2-3 months. prevents flare of inflammatory process. may allow recovery of adrenal-pituitary suppression

41
Q

What are characteristics of alternate day therapy (2)?

A

reduces side effects with chronic therapy metabolism/infection/growth. may prevent adrenal-pituitary suppression

42
Q

What are the therapeutic indications of corticosteroids (10)?

A

adrenal insufficiency, rheumatic disorders, renal disease, allergic disease, asthma, ocular, skin disease, GI diseases, organ transplantation, spinal injury

43
Q

Should you go look at the lecture practice problems?

A

probably.

Pharmacology Exam 5 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions