Corticosteroids Flashcards

1
Q

Describe the relative glucocorticoid and mineralocorticoid activity of commonly used steroids

(Fludrocortisone, Hydrocortisone, Prednisolone, Dexametasone)

A
  • Very high mineralocorticoid activity with minimal glucocorticoid activity with - Fludrocortisone
  • High mineralocorticoid activity with some Glucocorticoid activity - hydrocortisone
  • Mostly glucocorticoid activity but with low mineralocorticoid activity - Prednisolone
  • Very high glucocorticoid activity, minimal mineralocorticoid activity - Dexamethasone
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2
Q

What are some side effects of glucocorticoid?

A
  • Endocrine: impaired glucose regulation, increased appetite/weight gain, hirsutism, hyperlipidaemia
  • Cushing’s syndrome: moon face, buffalo hump, striae
  • Musculoskeletal: osteoporosis, proximal myopathy, AVN of the femoral head
  • Immunosuppression: increased susceptibility to severe infection, reactivation of tuberculosis
  • Psychiatric: insomnia, mania, depression, psychosis
  • Gastrointestinal: peptic ulceration, acute pancreatitis
  • Ophthalmic: glaucoma, cataracts
  • Suppression of growth in children
  • Intracranial hypertension
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3
Q

What are some side effects of mineralocorticoids?

A
  • Fluid retention
  • Hypertension
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4
Q

If someone is on long-term steroids and they get ill, what should be done?

A

Their dose of steroids should be doubled during the illness.

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5
Q

In what circumstances should a gradual withdrawal of systemic corticosteroids be done?

A
  1. A patient received >40mg of prednisolone daily for more than 1 week.
  2. Received more than 3 weeks of treatment
  3. Recently received repeated courses.
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