Corticosteroids Flashcards
Action
Systemic action to decrease inflammation and increase # and responsiveness of B2 receptors
Why are they used?
To increase the effectiveness of B2 agonist meds
Where do they act?
B2 receptors –> sympathetic NS
MOA
Reduce inflammation by decreased the number of mast cells and increasing the number and responsiveness of B2 receptors
Inhaled corticosteroids - adverse effects
Oral candidiasis
Dysphonia
Slowing of growth
Decreased bone density
What is another name for oral candidiasis?
Thrush
Why can oral candidiasis/thrush happen when taking an inhaled corticosteroid?
Some of the medication can get stuck in the mouth/oral cavity and leaves a white coating or patches on the tongue
How is oral candidiasis/thrush tx’d?
Oral antifungal
Which SEs can happen with prolonged use of an inhaled corticosteroid and especially in children?
Stunted growth
Decreased bone density
Why is dysphonia a common SE of inhaled corticosteroids?
The vocal cords are impacted so the patient can have a scratchy voice
Inhaled corticosteroids - clinical uses
Asthma maintenance
COPD maintenance
What are some common names for inhaled corticosteroids?
QVAR (beclomethadone) --> MDI Pulmicort (budesonide) ---> DPI/neb AeroBio (flunisolide) --> MDI/DPI Flovent (fluticasone) --> MDI/DPI Asmanex (mometasone) --> DPI Azmacort (triamcinolone) --> MDI
Inhaled corticosteroids - peak effect
1-2 weeks
Inhaled corticosteroids - duration
Most dosed 2 times daily
Systemic corticosteroids - use
For severe pulmonary issue (inhaled ones are best for lung issues)
Short-term use for flares of severe cases
Systemic corticosteroids - adverse effects - short-term use
Insomnia
Mental status changes (psychosis depending on use)
HYPERglycemia
ELEVATED WBC
Systemic corticosteroids - adverse effects - long-term effects
HTN
Osteoporosis
Adrenal SUPPRESSION
DECREASED growth in CHILDREN
What is another medication that someone taking a systemic corticosteroid long-term may get put on?
Anti-HTN (long-term use can elevate BP)
What is another condition besides HTN that someone taking a systemic corticosteroid can develop?
NIDDM
Why does adrenal suppression occur with long-term systemic corticosteroid use who is not weaned off appropriately or who is not handling being weaned off effectively?
The kidneys normally pulse out steroids, so oral use shuts down the adrenal glands bc the steroids are being produced externally but still being picked up in the BS - withdrawing steroid takes the adrenal glands a long time to pump out steroids again, and can cause shock because the hormones help retain BP (need to wean steroids slowly or adrenal won’t catch up - can die from adrenal suppression)
What is a fatal SE of long-term systemic corticosteroid use?
ADRENAL SUPPRESSION
