Corticosteroids/Adrenal Hormones Flashcards
2 corticosteroids for fetal lung maturation
Betamethazone
Dexamethazone
Preferred corticosteroid in pregnancy
Predisone
MOA of corticosteroids
Relief of inflammation. Results in decreased production of prostaglandins and leukotrienes. Also inhibits histamine.
Corticosteroid adverse effects
Glaucoma if patient is steroid responder
Increased risk of infection (decreases WBC and MO in the blood –> LN)
Cataracts- posterior sub capsular. Grainy.
Osteoporosis
Decreases growth in children
Oral corticosteroid side effects
Increase app Emotional Peptic ulcer Hypokalemia Peripheral edema HTN
Abrupt withdrawal of corticosteroids causes
Adrenal insufficiency. Can be lethal, cause exacerbation of disease or rebound. Must taper.
Adrenal function and hormone released
Adrenal medulla releases epinephrine (adrenaline)
Adrenal cortex releases adrenocorticosteroids - glucocorticoids (cortisol) and mineralocorticoids (Aldosterone) and androgens.
Cortisol effects
Breaks down glucose and lipids for energy
Decreases MO and WBC in the blood (not seen with NSAIDS)
Increases levels of RBC and NO and Platelets
Anti inflammatory–> stops production of prostaglandin by inhibiting phospholipase A2.
Aldosterone effects
Increases sodium reabsorption in the kidney–> water retention.
Increased by angiotensin II and potassium. Especially when NA levels are low.
Mineralcorticoid
Fludrocortisone. High salt retention, average anti inflammatory effect
Very strong anti inflammatory steroid
Dexamethasone.
Do most steroids have anti inflammatory and salt retention qualities?
Yes! Even just the glucocorticoids can cause salt retention–> edema, weight gain.
Main side effects of steroids
Glaucoma, increased risk of infection and poor wound healing, cataracts(PSC). This is with long systemic use
When to use glucocorticoids and mineralocorticoid antagonists
Tx of Cushing’s, diagnosis, adrenal tumors.
MOA: Metyrapone Aminogluthiamide ketoconazole Mifeprestone Spironolactone Epelerone
Blocks production of cortisol
Blocks production of all steroids
Blocks enzymes responsible for steroid production
Progestogen antagonist
Blocks Aldosterone and androgen receptors
Blocks Aldosterone receptor
