Corticosteroids Flashcards
Characteristics of Mineralcoticoids
- high fluid retention
- low anti-inflammatory effect
Potency of Mineralcoticoids
Most Potent
- Fludrocortisone
Less Potent
- Hydrocortisone
What is a Fludrocortisone indication
Postural Hypotension
Side effects of Mineralcoticoids
- potassium loss
- calcium loss
- Sodium + water retention (hypertension)
Characteristics of Glucocorticoids
- low fluid retention
- high anti-inflammatory
Potency of Glucocorticoids
High Potency
- Dexamethasone
- Betamethasone
Lower Potency
- Prednisolone
Side effects of Glucocorticoids
- diabetes
- osteoporosis
- gastric ulcers
- muscle wasting
All corticosteroids side effects
- central serous chorioretinopthy
- Insomnia
- Irritability
- suicidal thought
- Adrenal suppression
- infections
- stunts growth in children
- skin thinning
- Cushing’s syndrome
What is central serous chorioretinopthy
fluid build up under retina
(report visual disturbances)
Withdrawal of corticosteroids
not abruptly
What can prolonged use of corticosteroids cause
Adrenal Atrophy
(abrupt withdrawal can lead to hypotension or death)
What happen if corticosteroid patients experiences: Illness, Trauma or Surgery
- temporarily increase corticosteroid dose
- reintroduce if they stopped corticosteroid
Why are infections caused by corticosteroids
because they are immunosuppressants
What is Cushing’s syndrome
too much cortisol
How to manage Cushing’s syndrome
Metyrapone
How to manage corticosteroids skin side effects
- lowest effective dose for minimum period
- dose is OM
- can take total dose for 2 days on 1 day and alternate every other day
- intermittent short courses
At what dose strength of corticosteroid should a patient withdraw
> 40mg Prednisolone daily for > 1 week
(or equivalent)
How long should a patient be taking corticosteroids for, before they need to withdraw
> 3 weeks
What do a lot of steroid patients need
Steroid Card
How is Adrenal Insufficiency caused
- Addison’s Disease
- Congenital Adrenal Hyperplasia
What is Addison’s Disease
adrenal glands don’t produce enough of the hormones cortisol and aldosterone
How to treat Adrenal Insufficiency
- Hydrocortisone
- Fludrocortisone
What can adrenal insufficiency lead to
Adrenal crisis
What is Adrenal Crisis
- severe dehydration
- hypovolaemic shock
- seizures
- cardiac arrest
- death
How to treat adrenal crisis and why
Hydrocortisone
(because hydrocortisone is a mineralcorticoid, they have high fluid retention)
(good for dehydration)
