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Corticosteroids > Corticosteroids > Flashcards

Corticosteroids Flashcards

1
Q

The role of the adrenal glands is to…

Products??

A

Secrete mineralocorticoids, glucocorticoids, and sex hormones

Ex: Aldosterone (fluid control), cortisol, androgens (bone density, sexual desire, body maturation)

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2
Q

The primary functions of cortisol is to help regulate the following…

A

Mediate stress response
Regulate metabolism, inflammatory response, and immune system

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3
Q

Cortisol is released in response to ____

A

Stress

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4
Q

When stress resolves, cortisol also helps to…

A

Restore hormone levels

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5
Q

The short-term stress response involves…

Think of the different body systems

A

Increased HR, BP (SNS); changes in blood flow patterns
Increased BG (glycogen to glucose in liver)
Dilation of bronchioles
Increased metabolic rate

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6
Q

The long-term stress response involves…

Actions of mineralcorticoids and glucocorticoids long term lead to…

A

Mineralocorticoids - retention of sodium and water, increased BP and volume (RAAS)
Glucocorticoids - proteins + fats converted to glucose, increased BG, suppress immune system

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7
Q

Production and secretion of adrenal gland products is regulated via…

A

Hypothalamus-pituitary-adrenal (HPA) Axis

Connection between the brain and the adrenals

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8
Q

The hormone sequence that activates the adrenal glands is as follows:

A

Hypothalamus produces CRH, which makes pituitary secrete ACTH; which stimulates adrenals to release products.

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9
Q

The HPA-axis can regulate itself because cortisol works by…

Negative…

A

Negative feedback loop to prevent production of CRH and ACTH, stopping further production of cortisol + other adrenal products

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10
Q

Inflammation is a process where WBC’s and other mediators…

A

Protect against foreign substances

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11
Q

Long-term inflammation eventually becomes…

A

Unproductive to the body

Ex: Edema impeding blood flow

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12
Q

The inflammatory response often begins with stimuli, which triggers two factors…

A

Antigen-antibody response
Release of inflammatory mediators

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13
Q

Inflammatory mediators are directly correlated with…

guiding the immune cells to…

A

Cell mobilization to the tissue, often involving increasing capillary permeability

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14
Q

Common physical outcomes of inflammation involve…

Signs of injury

A

Edema
Erythema
Pruritis

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15
Q

Corticosteroids exert anti-inflammatory actions via

Impeding steps of the inflammatory process

A

Altering cytokine release
Blocking capillary permeability and less vasoactive substance release
Inhibiting leukocyte + macrophage migration/adhesion, and interfering with phagocytosis

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16
Q

Corticosteroids also have immunosuppressive qualities, which include…

Stopping immune response from even starting

A

Altering function of WBC’s, as well as cell function
Inhibiting T-cell activation, as well as interleukins, cytokines, and TNF-alpha synthesis

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17
Q

Corticosteroids have anti-mitotic activity, which means they can…

A

Inhibit DNA synthesis + epidermal cell turnover

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18
Q

Corticosteroids have shown anti-tumour effects, which may be related to the following…

Immune system? Tumour cell nourishment?

A

Inhibition of glucose transport, or induction of cell death in immature lymphocytes

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19
Q

Corticosteroids have anti-emetic effects, which may be due to…

A

Blockade of cerebral innervation of the emetic center

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20
Q

Corticosteroids are available as local dosage forms such as…

A

Otic, opthalmic, inhaled, topical

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21
Q

Corticosteroids are available as systemic agents, such as…

A

Injectables
Oral

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22
Q

Local agents may be more beneficial than systemic agents because…

A

Less adverse effects

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23
Q

Opthalmic/Otic corticosteroid formulations are often used for…

A

Redness, itching, swelling, and pain

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24
Q

A common issue with opthalmic/otic drops is…

A

Correct delivery technique (ex: administration of eyedrops)

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25
Q

Intranasal corticosteroids are often used for…

A

Rhinitis, polyps, and sinusitis

26
Q

Inhaled corticosteroids are standard of care for…

A

Asthma therapy

27
Q

Different dosage forms for topical corticosteroids include…

A

Lotions, creams, gels, and ointments

28
Q

Rank the topical dosage forms from most occlusive to least occlusive.

A

Ointment, gel, cream, lotion

29
Q

How is topical steroid potency arranged?

A

Scale from 1 to 7; 1 is ultra potent and 7 is mild.

30
Q

Effectiveness of topical steroids is based on a multitude of factors, such as…

A

Skin moisture, skin condition
Steroid potency, skin condition, and application technique
Site of administration

31
Q

Other dosage forms that a topical steroid could come in include…

Butt

A

Enemas, rectal ointments, rectal foams, and suppositories

Often used for inflammation, itching, and discomfort

32
Q

Corticosteroids are injected IV when…

Circumstance

A

A faster onset, or high doses are required

33
Q

IM corticosteroids onset of action is…

A

Delayed, and provides depot effects; pain relief varies

Depot = sustained action (but varies in people)

34
Q

An uncommon way to inject corticosteroids is…

Ick

A

Intralesional

35
Q

Intra-articular injections differ from IM injections since they have…

PK

A

A quicker onset and shorter duration

Suppress endogenous cortisol levels within 24-48 hours

36
Q

Usual sites for intra-articular injections include…

A

Hip, knee, ankle, shoulder, elbow, and wrist

37
Q

How frequently can a joint be injected?

A

3-4 times per year

38
Q

Oral corticosteroids PK shows that…

A

They exhibit rapid + complete absorption from the gut

Oral doses are equivalent to IV doses

39
Q

Oral corticosteroids are available as…

Dosage form?

A

Tablets or oral solutions

Budesonide unique - tablet/capsules

40
Q

Our bodies produce ____ cortisol per day

A

10-20mg

41
Q

Physiological dosing of corticosteroids are used to…

A

Replace deficiencies

Amount of cortisol excreted by adrenal cortex per day; ~5mg prednisone

42
Q

Pharmacologic dosing of corticosteroids are used to…

A

Treat disease states, and provide supportive therapy

43
Q

Low dose/maintenance dosing for pharmacologic treatment using oral CS is…

PREDNISONE equivalent

A

5-15mg/day

44
Q

Moderate dosing for pharmacologic treatment using oral CS is…

PREDNISONE equivalent, starting to base off weight

A

0.5mg/kg/day

45
Q

High dosing for pharmacologic treatment using oral CS is…

PREDNISONE equivalent, weight based

A

1-3 mg/kg/day

46
Q

A massive dose for pharmacologic treatment using oral CS is…

PREDNISONE equivalent, weight based

A

15-30 mg/kg/day

47
Q

Rank the corticosteroids based on their strength, from lowest to greatest

Care health professions put money (into) T D Bank

A

Cortisone, hydrocortisone, prednisone, prednisolone, methylprednisolone, triamcinolone, dexamethasone, betamethasone

Anti-inflammatory potency

48
Q

Corticosteroids may also have mineralocorticoid potency (sodium retention); which are…

Na-retaining potency correlates with…

A

The weaker corticosteroids - cortisone + hydrocortisone

Prednisone, prednisolone, methylprednisolone have some, but are less.

49
Q

These corticosteroids have a short duration of action…

A

Cortisone, hydrocortisone

8-12 hour half-life

50
Q

These corticosteroids have an intermediate duration of action…

A

Prednisone, prednisolone, methylprednisolone, triamcinolone

12-36 hour half-life

51
Q

Potency correlates with half-life, because…

A

Higher potency = Longer half-life (duration of action)

52
Q

These corticosteroids have a long duration of action…

A

Dexamethasone, betamethasone

36-72 hour half-life

53
Q

Equivalent dosing for cortisone is…

A

25mg

54
Q

Equivalent dosing for hydrocortisone is…

A

20mg

55
Q

Equivalent dosing for prednisone is…

A

5mg

56
Q

Equivalent dosing for prednisolone is…

A

5mg

57
Q

Equivalent dosing for methylprednisolone is…

A

4mg

58
Q

Equivalent dosing for triamcinolone is…

A

4mg

59
Q

Equivalent dosing for dexamethasone is…

A

0.75mg

60
Q

Equivalent dosing for betamethasone is…

A

0.75mg

61
Q

Equivalent dosing measurements can be used to…

A

Safely manage dosing adjustments between corticosteroids

Corticosteroids (5 decks)

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