Corticosteroids Flashcards
principle glucocorticoid steroid hormone
cortisol
precursor of all steroid hormones including cortisol
progesterone
what does cortisol do?
- released in response to stress and drops in serum glucose
- increases blood sugar via gluconeogenesis and glycogenolysis
- by raising blood glucose levels, glucocorticoids provide the energy necessary to respond to stressors such as trauma, infection, disease
physiological effects of glucocorticoids
- decrease lymphocytes, eosinophils, basophils, macrophages, monocytes
- decrease production of prostaglandins and leukotriens (anti-inflammatory effect)
- decrease histimine release
hydrocortisone
class indications: inflammatory, allergic, arthritis, auto-immune, organ transplant rejection prevention
inhaled nasal steroids
indications: allergic rhinitis
non-allergic rhinitis
nasal polyps
topical glucocorticoids
contact dermatitis eczema seborrhea psoriasis poison oak insect bites hemerrhoids
IV glucocorticoids
bacterial meningitis allergic response reactive airway disease septic shock blood transfusion reaction ITP
adverse effects of glucocorticoids
- reduced resistance to infection
- hyperglycemia
- DM
- severe bone loss
- easy bruising
- insomnia
- mental status changes
- weight gain
what happens when high dose glucocorticoid tx is stopped?
- need to ween off
- can have exacerbation of disease or acute adrenal insufficiency syndrome (Addisonian crisis)
most used glucocorticoids
- hydrocortisone
- prednisolone
- nonfluirnated (mthylprednisolone) and fluorinated prednisolones (betamethasone, dexamethasone)
triamcinolone
inhaled glucocorticoid
indication: COPD, asthma attack
SE: thrush, sore throat, ha, cough
beclomethasone / qvar
inhaled glucocorticoid
indication: prophylaxis of asthma or nasal spray for fhinitis
mineralocorticoids
aldosterone: regulates blood pressure by acting on renal tubule cells and decreasing resorption of potassium
fludrocortisone / florinef
mineralocorticoid agonist
indications: mineralocorticoid replacement for Addison’s disease or hyponatremia
MOA: Na retention
SE: salt retention, edema, HTN, rash, N/V
