Drugs inflammatory and related disorder_ Glucocorticoids

Question 1

syntheic dervative of cortisol drugs, _________,______that have equal glucocorticoid and mineralocorticoid activity of 1 with short duration

Answer 1

Cortisol, Hydrocortisone

Question 2

Glucocorticoid and Mineralocorticoid activity = 1; short duration

Answer 2

Cortisol, Hydrocortisone

Question 3

medium duration drugs that have:
Glucocorticoid activity = 4
mineralocorticoid activity = 0.3

Answer 3

Prednisone

Question 4

intermediate acting drug that have:
Glucocorticoid activity = 5 but
Mineralocorticoid activity = 0

Answer 4

Triamcinolone

Question 5

Long-acting drug that has:
glucocorticoid activity = 25 but
mineralocorticoid activity = 0

Answer 5

Betamethasone

Question 6

Long-acting drug that has:
glucocorticoid activity = 30 but
mineralocorticoid activity = 0

Answer 6

dexamethasone

Question 7

glucocorticoids uses

Answer 7

anti-inflammatory and immunosuppressive

Question 8

mechanism of actions of glucocorticoids

Answer 8

cellular effects:
- decrease leukocyte migration 
- increase lysosomal membrane stability ----> decrease 
   phagocytosis
- decrease capillary permeability 

biochemical actions:
- inhibits PLA2 (via Lipocortin expressions) --> decrease 
   PGs and decrease LTs 
- decrease platelet-activating factor
- interleukins (eg; IL-2 )

Question 9

Side effects of glucocorticoids

Answer 9

. suppression of ACTH: cortical atrophy; malaise; myalgia;
arthralgia; and fever
- may result in shock state with abrupt withdrawal
. Iatrogenic Cushingoid syndrome: fat deposition, muscle
weakness/ atrophy, bruising, acne
. Hyperglycemia: due to increase gluconeogenesis —————->increased insulin demand and other adverse effects
. Osteoporosis: vertebral fractures-aseptic hip necrosis
. Increase GI acid and pepsin release —> ulcer, GI
bleeding
. Electrolyte imbalance: Na+/H2O retention –>edema and
HTN, Hypokalemic alkalosis and hypo-Ca2+
. decrease skeletal growth in child
.decrease wound healing, increase infections (thrush)
. increase glaucome, cataracts (via sorbitol)
. increase mental dysfunction

Question 10

How to minimize steroidal toxicity

Answer 10

• Alternate-day therapy; local application (aerosols)

- Dose-tapering to avoid cortical suppression