Corticosteroids (Exam #3) Flashcards
Important immune system effect of Glucocorticoids?
ANTI-INFLAMMATORY
- Blocks all steps in inflammation (inhibits COX2)
Diagnosis of Cushing’s Syndrome, and what are the three steps? What do results indicate?
Dexamethasone Suppression Test
- Measure baseline cortisol in AM
- Administer Dexamethasone in PM
- Remeasure cortisol next AM
Disease if cortisol low
Syndrome if cortisol unchanged/high
What is the one Mineralocorticoid drug, and under what conditions should it be used?
Fludrocortisone
- Combine with glucocorticoid for Aldosterone replacement
What are the three classes of Glucocorticoids, and what are the differences between the three?
- 1st class: G = M effects
- 2nd class: G > M effects
- Other: almost all G effects
Two drugs in 1st class of Glucocorticoids? Which is the active form?
- Hydrocortisone (ACTIVE)
- Cortisone
Two drugs in 2nd class of Glucocorticoids? Which is the active form?
- Prednisone
- Prednisolone (ACTIVE)
Two drugs in other class of Glucocorticoids?
- Triamcinolone
- Methylprednisolone
Use of Hydrocortisone and Cortisone?
Replacement therapy in adrenal insufficiency
Use of Prednisone and Prednisolone?
Anti-inflammatory (more G than M effects)
Important note on each of the three main administrations of Glucocorticoids?
- Oral: long-term therapy
- Injections: emergency use
- Topical: caution systemic absorption if thin skin
Two general treatment options for chronic Adrenal Insufficiency?
- Glucocorticoid alone
- Glucocorticoid + Mineralocorticoid
When would treatment for chronic Adrenal Insufficiency be altered, and how?
Increase dose with stress or infection
- 2x for minor
- 10x for major (surgery, trauma)
If an inflammatory condition is present, what is the recommended treatment? What are three examples of inflammatory conditions?
GLUCOCORTICOIDS
- Asthma
- RA (inhaled)
- Rhinitis (intranasal)
What are three therapeutic guidelines for use of Glucocorticoids?
- Use lowest effective dose (taper as needed)
- Use local if possible
- Give on alternate days to avoid systemic AEs
With use of glucocorticoids, what is considered short-term therapy and what does this time frame reduce risk for?
1-2 weeks
- Short-term use is less likely to cause problems