CORTICOSTEROIDS

Question 1

What should be considered when starting oral corticosteroids?

Answer 1

• Age: children and older adults are more susceptible to adverse effects
• Medical history: Contraindicated with untreated systemic infection. Use cautiously in patients with other conditions
• Medication= check for interactions
• Immunisation= If patient is not up to date with vaccines, they need this before treatment

Question 2

How are corticosteroids compared?

Answer 2

Potencies are compared by their glucocorticoid effects

Note you need both glucocorticoid and mineralocorticoid activity for benefit

Question 3

What are mineralocorticoids

Answer 3

Class of corticosteroids
Produced in the adrenal cortex
Regulate sodium reabsorption and potassium excretion

Question 4

Which corticosteroids are short acting?

Answer 4

Cortisone
Hydrocortisone

Question 5

Which corticosteroids are intermediate acting?

Answer 5

Prednisolone
Prednisone
Methylprednisolone

Question 6

Which corticosteroids are long acting?

Answer 6

Betamethasone
Dexamethasone

Question 7

Why are Prednisolone and Prednisone used for long term disease?

Answer 7

Both drugs are glucocorticoids, mimicking cortisol to regulate inflammation and immune responses.
Long half life - suitable for daily dosing

Question 8

What are glucocorticoids ?

Answer 8

Class of corticosteroids
Secreted by the adrenal gland
CORTISOL is most important example= regulates immune system and regulates cellular metabolism

Question 9

What can high levels of cortisol cause

Answer 9

Insulin resistance and production of new glucose

Question 10

When should a corticosteroid dose be given (Preferably)

Answer 10

Dose in the MORNING
Minimises suppressive action on cortisol secretion

Question 11

Give some long term risks of corticosteroid therapy

Answer 11

HYPERTENSION due to fluid retention

ADRENAL SUPPRESSION

ADRENAL INSUFFICIENCY

INCREASED SUSCEPTIBILITY TO INFECTIONS: immunosuppression

PSYCHIATRIC RISKS - Depression, suicidal thoughts