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Pharmacology > Corticosteroids > Flashcards

Corticosteroids Flashcards

1
Q

What are the 3 different steroid hormones

A

Glucocorticoids, mineralcorticoids, sex steroids

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2
Q

Glucocorticoids

A

essential during stress, down regulates immune ststerm activity

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3
Q

Mineralcorticoids

A

essential for liffe, regulate Na/K levels

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4
Q

Sex steroids

A

androgens, estrogens, progestogens

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5
Q

What are corticosteroids synthesized from?

A

cholesterol within the adrenal cortex

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6
Q

What are most steroidgenic rxns catalyzed by

A

enzymes in the cytochrome P450 family

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7
Q

What are the physiological actions of glucocorticoids

A

metabolic effects

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8
Q

what are the pharmocological effects of glucocorticoids

A

anti-inflammatory, immunosuppressive and anti anaphylaxis, anti-shock, hematologic

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9
Q

What are the adverse effects of glucocorrticoids

A

GI, CNS exciting effects

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10
Q

What are the carb metabolism effects of corticosteroids

A

inc gluconeogenesis, dec peripheral utilization of glucose, inc glycogen deposition in liver

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11
Q

what are the protein metabolism effects of corticosteroids

A

breakdown of protein, mobilization of amino acid from periphery, negative nitrogen balance

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12
Q

Effects of carb and protein metabolism results in

A

diabetes like state state resistant to insulin, increased urea production, wasting of muscle lympholysis, thinning of skin

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13
Q

Effects of fat metabolism

A

increased lipolysis, decreased lipogenesis, inc breakdown of TGA, redistribution of fat- moon face

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14
Q

effects on electrolyes and H2O

A

enhanced Na reabsorption from the distal tubules of the kidney, will lead to fluid retention, an association inc in urinary excretion of K and H+, edema and hypertension common

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15
Q

What is the effect on anti-anaphylaxis

A

inhibits histamine release by basophils/mast cell

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16
Q

Antishock effects

A

dec inflammatory factors release, inc body resistance to bacterial endotoxin, permissive role as a vasopressor (effects angotensin), inc myocardial contractibility

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17
Q

Hematologic effects

A

stimulates hematopoiesis in bone marrow, RBC inc, Hgb inc, PLT inc

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18
Q

What do steroids do to the GI

A

increase gastric acid, increase pepsin

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19
Q

What do steroids do to the CNS

A

euphoria, can cause seizures at high doses, insomnia but rare

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20
Q

Symptoms of addison’s disease

A

fatigue, orthostatic hypotension, wt loss, changes in mood, arthralgias, hyperpigmentation

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21
Q

Lab abnormalities of addison disease

A

hyponatremia, hyperkalemia, hypercalcemia, hypoglycemia, eosinophilia, lymphocytosis, metabolic acidosis

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22
Q

What is treatment for addisons

A

replace cortisol with hypdocortisone or prednisone, replace aldosterone with fludocortisone

23
Q

What is a test for cushings

A

dexamethasone suppresion test

24
Q

Treatment for cushings

A

taper and stop corticosteroids, remove tumore if needed, ketoconazole, mifepristone

25
Q

Injectable steroids

A

betamethasone, dexamethosone, hydrocortisone, methylprednisolone, prednisolone, triamcinolone

26
Q

Oral steroids

A

betamethasone, fludrocortisone, methylprednisolone, prednisolone, prednisone

27
Q

Inhaled steroids

A

advair, symbicort, azmacort, asmanex twisthaler, flovent, aerobid, pulmicort, QVAR

28
Q

What are uses of hydrocortisone

A

antiinflammatory, replacement, shock, status asmaticus, ulcerativve colitis, crohns, thyroid storm

29
Q

Dosage of hydrocortisone

A

100 mg IV TID-QID, 20 mg PO daily, rapid but short acting

30
Q

Predisone/Predisolone uses

A

allergy, asthma, COPD, autoimmune, inflammation, malignancy

31
Q

What is DOC steroid for peds

A

prednisone

32
Q

Dosage of prednison

A

Chronic- 5-20 mg PO daily, if acute must taper 60 mg TID down to 10 mg PO TID

33
Q

Methylprednisolone uses

A

allergy, antiinflammatory, asthma, COPD, immunosuppressive, pulse therapy in non responsive RA, renal transplant

34
Q

What is potency and selectivity of methylprednisolone

A

more potent, GC selective

35
Q

Dosage of methylprednisolone

A

IV- 125 mg QID- aggressive; 60 mg TID middle; 40 mg BID low; can go up to 250 mg QID

36
Q

Triamcinolone use

A

arthritis injection, dermatoses, hay fever, MS

37
Q

What is potency and selectivity of triamcinolone

A

potent and GC selective

38
Q

Dexamethosone uses

A

antiemetic, cerebral edema, cushings, dexamethasone suppression test, MS, inflammayion, allergy, physiological replacement, shock

39
Q

Pearls of dexamthasone

A

very potent, highly selective GC, causes HPA suppression

40
Q

Betamethasone uses

A

bursitis, dermatologic, MS, peritendinitis, tenosynovitis, RA OA

41
Q

Betamehtasone PEARL

A

very potent selective GC

42
Q

Fludrocortisone use

A

congenital adrenal hyperplasia, orthostatic hypotension, replacement for Addison’s

43
Q

Pearl of fludrocortisone

A

potent MC, some GC, dont use for inflammation or immunosuppression

44
Q

what renal diseases can steroids treat

A

nephrotic syndrome in children, renal disease ssecondary to SLE, renal sarcoidosis, glomerulonephritis

45
Q

What other immunosuppressants are steroids combined with for organ transplant

A

cyclosporine, azathioprine

46
Q

What infectious dissease can steroids treat

A

AIDs and pneumocystis carinii pneumonia, haemophilus influenza meningitis, tubercular meningitis, sepsis

47
Q

Steroids are essential for what malignancy

A

ALL, hodgkin’s or other lymphoma, hormone responsive breast cancer, can provide symptomatic relief in other CA

48
Q

Other uses of steroids

A

acute mountain sickness, aspiration pneu, pulmonary edema, cerebral edema, thyroid storm, idiopathic thrombocytopenic purpura

49
Q

Short term admin ADRs

A

insomnia, inc appetite, wt gain, behavioral, peptic ulcer

50
Q

Steroid withdrawal

A

weakness, fatigue anorexia, arthralgias, wt loss, NVD, hypoglycemia, fainting, hypotension, shock, death

51
Q

Warnings of steroids

A

CVD, DM, peptic ulcer, hepatic impairment, MI, osteoporosis, seizure disorder, glaucoma, infection, HTN

52
Q

Contraindication of steroids

A

systemic fungal infection

53
Q

Long term steroid ADR

A

CVD, metabolc, endocrine, skeletal, GI, hypokalemia, neuropsychiatric, immune function

Pharmacology (61 decks)

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