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AS - N926 Pharmacology > Corticosteroids > Flashcards

Corticosteroids Flashcards

1
Q

Hypothalamus

A 
Produces hormones (CRH)
Regulating body temperature
Physiological cycles
Controls appetite
Managing sexual behavior & emotional responses
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2
Q

Anterior Pituitary Gland

A 
Adrenocorticotropic hormone (ACTH)
Thyroid stimulating hormone (TSH)
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3
Q

Posterior Pituitary Gland

A

Oxytocin & ADH

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4
Q

Adrenal Gland

A

Adrenal cortex

  • Zona glomerulosa (aldosterone)
  • Zona fasiculata (cortisol)
  • Zona reticularis (sex hormones)

Adrenal medulla - Epi & NE

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5
Q

Hypothalamic Pituitary Adrenal Axis

A

Hypothalamus releases CRH
Anterior pituitary release ACTH
Cortisol

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6
Q

Cortisol (Hydrocortisone)

A

Carbohydrate metabolism (gluconeogenesis)
↑ protein catabolism
Inhibits insulin from shuttling into cells
Mobilized free fatty acids
Pro-inflammatory cytokine suppression
Suppress immune system

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7
Q

When are cortisol levels highest?

A

8am

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8
Q

Normal Cortisol Production

A

15-30mg/day

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9
Q

Surgery Cortisol Levels

A

Minor 50mg/day returns to baseline w/in 24hrs
Moderate 75-100mg/day returns to baseline day 5
Major 200mg/day returns to baseline day 5

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10
Q

Cushing’s Syndrome

A

Corticosteroids overuse
Adrenal gland abnormality
Pituitary gland tumors
Ectopic adrenocorticotropic ACTH-releasing tumors

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11
Q

Addison’s Disease

A

Primary adrenocortical insufficiency
Tuberculosis worldwide
Autoimmune destruction
Congenital, malignancy, infection

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12
Q

2nd Adrenal Insufficiency

A

Traumatic brain injury
Ischemic or hemorrhagic lesions HPA
Chronic glucocorticoid treatment 3-4wks
Topical administration

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13
Q

Adrenal Crisis

A 
Acute health deterioration
Hypotension - absolute & relative
Acute abdominal symptoms 
N/V
Altered mental state
Fatigue
Fever
Hyponatremia
Hyperkalemia
Hypoglycemia
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14
Q

Adrenal Crisis Causes

A 
Glucocorticoid intake interruption
Infection
Surgery
Gastroenteritis
Stress
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15
Q

Mineralocorticoid Effect

A

Na+/K+ reabsorption
Exchange in renal distal tubules
Receptors at kidney

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16
Q

Glucocorticoid Effect

A

Anti-inflammatory properties

17
Q

Corticosteroids MOA

A

Stimulate changes in 456 DNA transcription
- Protein synthesis
Target cells contain 11-beta hydroxysteroid dehydrogenase (Etomidate)
Cortisol (active) to Cortisone (inert)

18
Q

Corticosteroids PK

A 
Antacids interfere w/ PO absorption
Highly protein 90%
Readily crosses placenta
Elimination half-life 1.5-3hrs
70% conjugated in liver to inactive metabolites
19
Q

Corticosteroid Clinical Uses

A 
Anti-emetic
Analgesia
Immunosuppression
Laryngeal edema
Regional blocks
Asthma
Cerebral edema
Adrenal insufficiency
20
Q

Hydrocortisone

A

Cortisol

Short-acting

21
Q

Prednisolone

A

Sole replacement therapy in adrenocortical insufficiency

22
Q

Prednisone

A

PO administration

Rapidly converted to prednisolone after absorption from GI tract

23
Q

Methylprednisolone

A

Used to produce intense glucocorticoid effect

24
Q

Dexamethasone

A

Multiple uses

Primarily inflammation

25
Q

Drug Interactions

A

Enzyme inhibition

  • Ketoconazole
  • Fluconazole
  • Etomidate
  • Metapyrone

Accelerate metabolism

  • Phenytoin
  • Rifampin
  • Phenobarbital
  • Ephedrine
26
Q

Corticosteroid Chronic SE

A 
HPA suppression
Corticosteroid supplementation
Electrolyte & metabolic changes
CNS dysfunction
Peptic ulcer disease
Skeletal muscle myopathy
27
Q

Corticosteroid Acute SE

A 
Hyperglycemia
Delayed wound healing
Infection
Cancer recurrence
CNS/GI disturbances
Affects on Sugammadex
28
Q

Primary Glucocorticoids

A

Anti-inflammatory

Prednisolone/Prednisone, Methylprednisolone, Betamethasone, Dexamethasone, Triamcinolone

29
Q

Primary Mineralocorticoids

A

Sodium retention

Fludrocortisone & Aldosterone

AS - N926 Pharmacology (18 decks)

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