Corticosteroids

Question 1

Toxic effects of glucocorticoids

Answer 1

• impaired wound healing, skin and CT thinning
• increase intra-ocular pressure and glaucoma
• fluid retention and hypertension
• decreased bone mineralization

Question 2

Glucocorticoids metabolic effects

Answer 2

• Iatrogenic cushings disease (higher levels of cortisol than normal)
• increased BG and dysregulation of diabetes mellitus esp. in cats.
• calcinosis cutis (calcium deposits in skin), steroid ear curl,laminits.

Question 3

Acetate and Acetonide esters

Answer 3

• poorly water soluble
• Given IM, SC or intra-articular for prolonged effect
• ALWAYS depresses the HPA axis
• immunosupressive
• methylprednisolone acetate(depo medrol), isoflopredone (predef 2x) (hypokalemia in horses in cattle), prednisolone acetate.

Question 4

Phosphate and succinate esters

Answer 4

• water soluble with rapid onset of action, used for shock (IV, high dose), expensive.
• methylprednisolone sodium succinate, prednisolone sodium succinate and dexamethasone sodium phosphate

Question 5

Free Steroid Alcohols

Answer 5

• Administer IV or IM (Water soluble)
• Use in acute but not life threatening cdns : Resp (heaves), vaccine reactions, insect bite hypersensitivity.
• Dexamethasone (Azium, Dixazone, Dexamone 2) (pot = 25) and Flumethasone (Flucort)(pot = 40)

Question 6

Oral Glucorticoids

Answer 6

-Prednisone, prednisolone (pot 4) and dexamethasone (pot 25)

Question 7

Inhaled steroids

Answer 7

• Used for feline asthma, recurrent airway obstruction (RAO), canine bronchitis
• Beclomethasone diproprionate (beclovent)
• fluticasone (Flucort)

Question 8

Topical formulations

Answer 8

Opthalmic, otic, dermal products
Get systemic absorption which depends on the site of absorption, inflammation/bandages and fluorinated products are more potent.

Question 9

Emergency steroid therapy

Answer 9

phosphate and succinate esters or alcohol solutions

Question 10

Short term vs long term steroid therapy

Answer 10

short term = 2 weeks. if greater than this must wean off therapy.

Question 11

Repositol steroids

Answer 11

where dosing is challenging. Only used when inflammation is likely to persist, is localized, oral difficult to give or owner is unlikely to follow treatment schedule . See most issues with adrenal suppression or neg effects.