Corticosteroids and Uterine drugs Flashcards
What effect do glucocorticoids have on the body?
They are responsible for mobilizing glucose, they redistribute fat from the extremities to central obesity
What are the 3 main cardiovascular effects of glucocorticoids?
- Increase vascular responsiveness to sympathetic stimulation
- Some Na+ & H2O retention
- Increase cardiac output
What are other endocrine effects of glucocoricoids?
ultimately leads to a decrease in ACTH, leading to a decrease in GH, TSH, and LH. Leads to a decrease of Vitamin D activation and an increase in PTH, all leading to an increase in bone resorption, also increased EPI from adrenal medulla.
How do glucocorticoids suppress wound healing in later stages?
by inhibiting collagen synthesis and deposition
Other negative effects of glucocorticoids
CNS: Mood elevation, Insomnia, restlessness, Anxiety, Depression, Psychosis
GI: Associated with peptic ulcer development
Which drugs exhibits both mineralocorticoid and glucocorticoid properties? What are they used for?
hydrocortisone and cortisone; To treat chronic adrenal insufficiency (Addison’s)
What is the most commonly prescribed oral glucocorticoid? Which drug is it converted to in the body? What kind of activity do they have?
Prednisone; Prednisolone; More glucocorticoid than mineralocorticoid effects
Which drugs have: virtually no mineralocorticoid activity High glucocorticoid activity Most newer glucocorticoid drugs are like these drugs Differences in duration and potency
Triamcinolone (Kenalog), Methylprednisolone (Medrol)
What drug do you give if you are concerned if you are treating an Addison’s patient and you don’t want to give too much glucocorticoid but you need more of a mineralocorticoid effect?
Fludrocortisone
How would you treat a patient in acute Addisonian crisis? They will wear a bracelet
IV CORTISOL (Hydrocortisone). INCREASE DOSE 2X WITH MINOR STRESS AND 10X FOR MAJOR STRESS (Emergency bracelet)!
What are signs of mineralocorticoid insufficiency?
hyperkalemia, hyponatremia, dehydration
Which asthma med is useful only when used in combination with ICS?
LABA
How will you cause Addison’s in a patient who you fail to wean off of glucocorticoids?
Because endogenous cortisol can stay too low for up to 6 months, suppression of ACTH until this long which can cause an adrenal crisis in Addison’s disease (or without) due to insufficient adrenal hormones
What are two important points to remember about administration of glucocorticoids?
- Chronic treatment may leave the HPA subnormal for months
- Short-term therapy (1-2 weeks) is not likely to cause serious problems, though CNS effects are almost overnight (psychoses, etc) PT EDUCATION IMPORTANT!
What are major adverse reactions of corticosteroid use? KNOW THIS
Infections –May mask symptoms –More susceptible to serious infections •Hyperglycemia –May unmask diabetes in some patients •CNS –Restlessness, insomnia, psychoses, ↑appetite –Even with acute treatments OSTEOPOROSIS
