Corticosteroids

Question 1

M?

Answer 1

Mech
• Corticosteroids bind to glucocorticoid receptors and translocate to the nucleus, bind to GRE’s and supress NFKB from binding to DNA and increasing pro-inflammatory gene expression
• They also upregulate expression of anti-inflammatory genes
• Suppress stimulants and numbers of leucocytes
• Increased gluconeogenesis/mineralocorticoid effects

Question 2

I?

Answer 2

Indications
• Treat allergic or inflammatory disorders
• Suppress autoimmune disease
• Treat cancers as chemotherapy or to reduce tumour-linked swelling
• Hormone replacement in adrenal insufficiency or hypopituitarism

Question 3

C?

Answer 3

Contraindications
• Increased risk of peptic ulceration and GI bleeding when used with NSAIDs and enhance hypokalaemia in pts with B2 agonists. Theophylline and loop/thiazide diuretics
• Cytochrome p450 inducers
• Reduced immune response to vaccines

Question 4

A?

Answer 4

Adverse Effects
• Immunosuppression
• Diabetes mellitus and osteoporosis-increased OC and less OB-more breakdown of bone
• Cushing’s syndrome
• Mood/behavioural changes
• Hypertension, hypokalaemia and oedema-mc actions
• Adrenal atrophy and CVS collapse if taken off suddenly-lack of ACTH production
• Chronic glucocorticoid deficiency