Corticosteroids Flashcards
1
Q
Corticosteroids?
A
- Corticosteroids are amongst the most commonly prescribed therapies in clinical practice.
- They are used both systemically (oral or intravenous) or locally (skin creams, inhalers, eye drops, intra-articular).
- They augment and in some cases replace the natural glucocorticoid and mineralocorticoid activity of endogenous steroids.
2
Q
Fludrocortisone?
A
- Minimal glucocorticoid activity,
- very high mineralocorticoid activity,
3
Q
Hydrocortisone?
A
- Glucocorticoid activity,
- high mineralocorticoid activity,
4
Q
Prednisolone?
A
- Predominant glucocorticoid activity,
- low mineralocorticoid activity
5
Q
Dexamethasone?
Betmethasone?
A
- Very high glucocorticoid activity,
- minimal mineralocorticoid activity
6
Q
- The side-effects of corticosteroids are numerous and represent the single greatest limitation on their usage.
- Side-effects are more common with systemic and prolonged therapy.
- (Glucocorticoid side-effects)
A
Glucocorticoid side-effects:
- endocrine: impaired glucose regulation, increased appetite/weight gain, hirsutism, hyperlipidaemia
- Cushing’s syndrome: moon face, buffalo hump, striae
- musculoskeletal: osteoporosis, proximal myopathy, avascular necrosis 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
7
Q
Mineralocorticoid side-effects?
A
- fluid retention
- hypertension
8
Q
Selected points on the use of corticosteroids?
A
- patients on long-term steroids should have their doses doubled during intercurrent illness
- the BNF suggests gradual withdrawal of systemic corticosteroids if patients have:
- received more than 40mg prednisolone daily for more than one week,
- received more than 3 weeks treatment or recently received repeated courses
