Endocrine - Corticosteriods

Question 1

What is diabetes insipidus

Answer 1

urinating a lot and excessive thirst
nocturnal is also known as bed wetting

Question 2

What is used to treat diabetes insipidus

Answer 2

Desmopressin

Question 3

What is desmopressin?

Answer 3

It is an analogue of vasopressin. It is preferred because it is more potent, has a longer duration and doesn’t have the cardiovascular risk

Question 4

When taking desmopressin side effect(s) can occur

Answer 4

HYPONATRAEMIA [CONVULSION]
and Nausea

Question 5

How do you decrease the risk of HYPONATRAEMIA? [5]

Answer 5

• Drink to quench thirst
• Don’t drink 1-2hrs before bed
• Don’t drink 8hrs after thanking this medicine
• Avoid ibuprofen and aspirin
• Sick Day Rule: Stop when vomiting and diarrhoea

Question 6

List MINCERALCORTICODS from least to most potent

Answer 6

Least:
- Prednisolone, Methylprednisolone, triaminalone
- Hydrocortisone, Corticotrophin, Tetracosactide
- Fludrocortisone
MOST

Question 7

What are some of the things corticosteroid’s can be used to treat (11)

Answer 7

Postural Hypotension
Raised Intracranial Pressure
Palliative Care
Asthma
COPD
IBD
Eczema
Anaphylaxis
Surgery
Transplant Organ
Immunosuppressant

Question 8

What is more potent MINERALCORTICOID or GLUCOCORTICOID

Answer 8

Action of MICROCORTICOID is insignificant to Highley Potent GLUCORTICOID.
Betamethasone and Dexamethasone

Question 9

When is MINERALCALOIDS used?

Answer 9

in Fluid retention
when fluid retention is beneficial
- Fludrocortisone e.g. Postural Hypotension or Adrenal Insufficiency e.g. Addison’s bc Septic Shock
give low dose

Not long-term disease impression
- Hydrocortisone e.g. Surgery or Emegancys such as asthma and thyrotoxicosis
give low dose

Question 10

When is Glucorticosteroid used (Its an Anti-allergy)

Answer 10

When fluid retention isn’t beneficial
- Betamethasone/Dexamethason - heart failure

• Prednisolone - Asthma, COPD, IBD
  and used in Surgery & Emergancy e.g. Anaphylaxis
  (most common PO)

Question 11

What are side effects of corticosteriods? (17)

Answer 11

Adrenal suppression, Appetite increase, Abrupt withdrawal syndrome
Cushing syndrome, Cataract
Hyperglycemia (Diabetes), Hypolipidemia
Infection risk, Intracranial Pressure
Nervous: Psychiatric reaction
Glaucoma, GI Ulcers
Blood pressure increase = HYPERTENSION
Osteoporosis
Skin thinning
Obesity
Muscle wasting

Question 12

You are a hospital pharmacist clinical checking a 47-year-old man’s prescription of methylprednisolone 30mg injections to treat severe asthma. When you review his chart you see he’s allergic to cow’s milk. Why would you contact the prescribing doctor?

• His son is too young to take corticosteroid
• The dose is too high for his age
• Prednisolone is not indicated for this disease
• He needs to be able to drink cows’ milk to have it
• Dose is too high for the prescription for this disease

Answer 12

Safety Imporant Information:
Do not use in patients with cow’s milk allergy. S

Question 13

What counselling points would you give during the handout

Answer 13

Take first thing in the morning
Take with or after food
Don’t stop taking abruptly
It can increase the risk of infection (avoid chicken pox and mesels)
Can cause a psychiatric reaction: report if paranoid and depressed with suicidal thoughts
Carry a steroid alert card
Can cause adrenal suppression: hypotension, death
Can cause weight gain