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PHA223 > corticosteroids 2 > Flashcards

corticosteroids 2 Flashcards

1
Q

How do corticosteroids affect carbohydrate/protein metabolism?

A
  • increase gluconeogenesis
  • decrease peripheral utilisation of glucose
  • increase glycogen deposition in the liver
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2
Q

How do corticosteroids affect lipid metabolism?

A
  • cause redistribution of fat, Buffalo hump, moon face (Cushing’s effects)
  • promote adipokinetic agents activity (glucagon, GH, AD, thyroxine)
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3
Q

How do corticosteroids affect electrolyte and water balance?

A

ALDOSTERONE
acts on distal convoluted tubule and collecting duct of the kidney
- increase Na reabsorption
- increase urinary excretion of K and H

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4
Q

electrolyte and water balance and corticosteroids and how it relates to Addison’s disease

A

Addison’s disease -> decreased aldosterone

  • Na loss
  • decreased K excretion (hyperkalaemia)
  • decrease in ECF volume
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5
Q

How do corticosteroids affect the cardiovascular system?

A

restricted capillary permeability
maintain tone of arterioles
myocardial contractility

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6
Q

How do corticosteroids affect skeletal muscles?

A

needed for maintaining the normal function of skeletal muscles

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7
Q

What causes weakness and fatigue in Addison’s diaease?

A

inadequacy of the circulatory system

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8
Q

What can prolonged use of stroids lead to in relation to skeletal muscle?

A

skeletal muscle wasting
-> steroid myopathy
(weakness and fatigue)

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9
Q

How do corticosteroids affect the CNS directly?

A

mood
behaviour
brain excitability

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10
Q

How do corticosteroids affect CNS indirectly?

A

maintain glucose, circulation and electrolyte balance

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11
Q

What can increase in ICP lead to in relation to CNS?

A

pseudotumour cerebri

  • intracranial hypertension
  • headaches and vision problems
  • rare
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12
Q

What increases the risk of pseudotumour cerebri?

A 
glucocorticoids
mineralocorticoids
amiodarone
vitamin A
oral contraceptives
tetracyclines
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13
Q

How do corticosteroids affect the stomach?

A

can cause peptic ulcers

  • increased acid and pepsin secretion
  • decreased immune response to H. Pylori
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14
Q

How do corticosteroids affect the blood (RBC)?

A

increase Hb and RBC content

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15
Q

How do corticosteroids affect the blood (WBC)?

A

decrease - lymphocytes, eosinophils, monocytes, basophils

increase - polymorphonucleocytes

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16
Q

Corticosteroids and anti-inflammatory and immunosuppressive effects

A
  • they suppress of hypersensitivity and allergies
  • high dose - interfere with steps of immunological response
  • suppression of CMI (cell mediated immunity) in graft rejection
17
Q

What do cortocosteroids suppress in anti-inflam/immunosuppression?

A

hypersensitivity and allergic reactions

18
Q

How do corticosteroids help with transplant rejection?

A

decrease antigen expression from grafted tissue
delay revascularisation
decrease sensitisation of T lymphocyles

19
Q

What effect do corticosteroids have on inflammatory cells?

A
  • decrease neutrophil release
  • decrease activation of neutrophils, macrophages, mast cells
  • decrease activation of T-helper cells
  • decrease switch from Th1 to Th2 immune response
20
Q

corticosteroid effect on the infammatory mediators

A
  • dec prostanoids
  • reduced expression of COX2
  • dec cytokines (IL2, IL-4, TNF alpha)
  • dec nitric oxide synthase 2 (NOS2)
  • dec complement
  • dec histamine
  • dec IgG production
  • INCREASED synthesis of anti-inflamm mediators (IL-10, annexin-1)
21
Q

summary of how steroids effect the immune system

A

block:

  • T cell activation
  • cytokine production
  • mast cell release of histamine, PGs and leukotrienes
  • eosinophils
22
Q

What do steroids increase in their effect on the immune system?

A

increase anti-inflammatory factors

  • IL-10
  • IL-1
  • annexin 1
23
Q

How do corticosteroids work with calcium metabolism?

A
  • decrease intestinal absorption
  • increase renal excretion
  • excessive loss of Ca from spongy bones (ribs, vertebrae)
  • > osteoporosis
24
Q

How do corticosteroids work on the respiratory system?

A
  • effective anti-inflammatory
  • effects not seen immediately (6hrs)
  • inhaled used for long term use
25
Q

Are corticosteroids bronchodilators?

A

no

26
Q

steroid with the highest glucocorticoid effect

A

dexamethasone

27
Q

steroid with the highest mineralocorticoid effect

A

aldosterone and fludrocortisone

28
Q

steroid with the highest anti-inflammatory effect

A

betamethasone

dexamethasone

29
Q

steroid with the highest salt retaining ability

A

fludrocortisone

30
Q

steroids with the highest topical effects

A

betamethasone
dexamethasone
fludrocortisone

31
Q

short acting steroids

A

cortisol

cortisone

32
Q

intermediate acting steroids

A 
prednisone
prednisolone
methylprednisolone
triamcinolone
paramethasone
fluprednisolone
33
Q

long acting steroids

A

betamethasone

dexamethasone

34
Q

mineralocorticoids

A

fludrocortisone

DOCA

35
Q

steroid preparations

A
  • glucocorticoids (short, intermediate, long acting)
  • mineralocorticoids
  • inhaled
  • topical

PHA223 (43 decks)

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