Corticosteroids

Question 1

Describe the corticosteroid cycle

Answer 1

Hypothalamus releases CRH
Anterior Pituitary responds by releasing ACTH (corticotrophin)
Adrenal Medulla responds by releasing corticosteroids
Corticosteroids negatively feed back to hypothalamus and anterior pituitary,

Question 2

What are the groups of corticosteroids?

Answer 2

Mineralocorticoids= Aldosterone
Glucocorticoids= CORTISOL

Question 3

What do steroid responses in cells cause?

What are the resultant side effects?

Answer 3

Decreased: Inflammatory response, immunological response, glucose utilisation= Diabetes risk and infection risk
Increased: Liver glucose deposition, Gluconeogenesis, Protein catabolism, Bone catabolism= Osteoporosis risk and Peptic ulcers

Question 4

What is the function of Aldosterone?

Answer 4

Causes sodium retention

Question 5

What is the function of Cortisol?

Answer 5

Affects carb and protein metabolism

Also affects mineralocorticoids (but more RAAS)

Question 6

What are synthetic glucocorticoids used for?

Answer 6

Addisons- reduce inflammation an immune response
Transplants
in Leukaemias and lymphomas

Question 7

Name 6 glucocorticoids

Answer 7

Hydrocortisone
Prednisolone
Betamethasone
Dexamethasone
Beclometasone Diproprionate
Budesonide

Question 8

What steroid would you use for asthma and eczema due to its inability to pass through membranes?

Answer 8

Budesonide

Beclometasone Diproprionate

Question 9

Which would you use in high dose for cerebral oedema because it has no Na activity?

Answer 9

Dexamethasone

Betamethasone

Question 10

What steroid would you give orally in inflammatory disease?

Answer 10

Prednisolone

Question 11

Which steroid is used for anaphylactic shock, IV shock, status asthmasticus etc?

Answer 11

Hydrocortisone

Question 12

What are the metabolic SEs of steroids?

Answer 12

Rounded moonface due to fat redistribution from trunk to face
Purple striae and bruises
Hyperglycaemia and diabetes
Muscle wasting and weakness due to protein loss
Osteoporosis risk

Question 13

How do steroids affect fluid balance?

Answer 13

Fluid retention
Hypokalaemia
Hypertension
All due to adrenal supression which takes 6-12 months to recover and steroids must be stopped slowly

Question 14

What are the other side effects of steroids?

Answer 14

Psychosis
Cataracts and glaucoma
Peptic Ulceration
Nascent infections reactivated ie TB