Corticosteroids (general use) Flashcards
Can corticosteroids be used to treat psoriasis?
Should avoid the use of them or use them only under specialist supervision.
Corticosteroids are used both topically, via the rectum, and systemically, via the mouth or IV, in the management of [2]
ulcerative colitis and Crohns disease.
In what form can corticosteroids be used for haemorrhoids?
Topically.
When would the mineralcorticoid activity of fludrocortisone acetate be used to treat postural hypotension?
autonomic neuropathy
Lower doses of what [2] corticosteroids is of benefit in adrenocortical insufficiency resulting from septic shock?
Hydrocortisone
Fludrocortisone acetate
Dexamethasone and betamethasone have little if any action of what type? Why is this, along with their long duration of action, useful?
Dexamethasone and betamethasone have little if any mineralocorticoid action and their long duration of action makes them particularly suitable for suppressing corticotropin secretion in congenital adrenal hyperplasia where the dose should be tailored to clinical response and by measurement of adrenal androgens and 17-hydroxyprogesterone.
What two corticosteroids are particularly suitable for suppressing corticotropin secretion in congenital adrenal hyperplasia?
Why?
Dexamethasone and betamethasone have little if any mineralcorticoid action and their long duration of action makes them suitable.
In the treatment of congenital adrenal hyperplasia how should the dose of either dexamethasone and betamethasone be tailored?
To clinical response and by measurement of adrenal androgens and 17-hydroxyprogesterone.
In common with all glucocorticoids, the suppressive action of both dexamethasone and betamethasone on the hypothalmic-pituitary - adrenal axis is greatest and most prolonged when?
Given at night.
What is the basis of the overnight dexamethasone test?
What is used to help diagnose?
In most individuals, a single dose of dexamethasone at night is sufficient to inhibit corticosteroid secretion for 24 hours.
The overnight dexamethasone suppression test is used for diagnosing Cushing’s syndrome.
What other conditions are betamethasone and dexamethasone appropriate for, apart from the treatment of congenital adrenal hyperplasia?
Those where water retention would be a disadvantage.
In what circumstances would it be appropriate to prescibe a corticosteroid for ailments of the brain?
In the management of raised intracranial pressure or cerebral oedema that occurs as a result of malignancy (pallative care): high doses of betamethasone or dexamethasone are usually used.
How are corticosteroids usually commenced in the treatment of serious conditions such as systemic lupus erythematosus, temporal arteritis, and polyarteritis nodosa?
It is usual to begin therapy at a high dose and then to reduce the dose to the lowest commensurate with disease control.
What are the 5 most common mineralocorticoid side effects seen with overdosage or prolonged usage of corticosteroids?
Hypertension Sodium retention Water retention Potassium loss Calcium loss
Mineralcorticoid side effects are seen most frequently with which corticosteroids?
- Fludrocortisone
2. Significant with hydrocortisone, corticotropin and tetracosactide.
