Corticosteroids Flashcards
What glucocorticoids have mineral corticoid effects? What are these effects?
Prednisone and cortisol, Na retention
Cortisol Physiological Actions
Activates gluconeogenesis and hyperglycemia
Activates catabolsim of protein and lipids
Maintains blood volume
Maintains vascular function (BP)
Anti-inflammatory/Immunosuppression
Where does cortisol bind?
GRE in the nucleus which increases liver gluconeogenesis, protein catabolism genes and liver catabolism genes
How does cortisol have repression of anti inflammatory?
When GRE gets to NFKB there is a decrease in prostaglandins, leukotrienes and cytokines
Effects of corticosteroids on immune cells
- inhibition of migration from vascular spine to site of injury (decreased adhesion molecules for leukpcyte localization)
- inhibition of phospholipase A2 and cyclooxygenase-2(decreases prostaglandins and leukotrienes)
Effects of corticosteroids on mast cells and basophils
decrease histamine release
Effects of corticosteroids on monocytes and macrophages
decrease production of proinflamatory cytokines, decreases chemotaxis response, and decreased differentiation into macrophages
corticosteroid effects on lymphocytes
decreased t cell response to antigens, mitogen, decreased proliferation, and decreased proinflammatory expression
net effect of cortico steroids on immune suppression
immunosupression, anti-inflammatory (palliative care not curative), decrese pain and tissue destruction
short acting cortico steroids
cortisol
intermediate acting corticosteroids
prednisone, triamcinolone
long acting corticosteroids
dexamethasone and betamethasone
other corticosteroids
fluticasone- inhaled (reduces systemic effects))
fluocinonide - topical
toxicity of corticosteroids
continued use or via withdrawal
conintued use of corticosteroids
iatrogenic cushings (HTN, susceptibility to infection, osteoporosis, Gi ulcers)
decrease resposne to stress
