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
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
3
Q
What are some side effects of mineralocorticoids?
A
- Fluid retention
- Hypertension
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.
5
Q
In what circumstances should a gradual withdrawal of systemic corticosteroids be done?
A
- A patient received >40mg of prednisolone daily for more than 1 week.
- Received more than 3 weeks of treatment
- Recently received repeated courses.