Endocrine: Glucocorticoid therapy

Question 1

High glucocorticoid activity is of no benefit unless accompanied by what?

Answer 1

Relatively low mineralcorticoid activity.

The mineralcorticoid activity of fludrocortisone acetate is so high that its anti-inflammatory activity is of no clinical relevance.

Question 2

What properties of hydrocortisone make it unsuitable for disease suppression on a long-term basis?

Answer 2

Relatively high mineralcorticoid activity leading to fluid retention.

Can be used for adrenal replacement therapy or on a short-term basis by IV in emergencies and also topically for inflammatory skin conditions.

Question 3

What corticosteroids (which sound really similar) have predominatly glucocorticoid activity?

Which one is the corticosteroid most commonly used by mouth for long-term disease suppression?

Answer 3

Prednisolone and prednisone have predominantly glucocorticoid activity. Prednisolone is the corticosteroid most commonly used by mouth for long-term disease suppression.

Question 4

Betamethasone and dexamethasone have what properties which make them particularly suitable for both high-dose therapy in conditions where fluid retention would be a disadvantage and also for conditions which require suppression of corticotropin secretion?

Answer 4

1. Very high glucocorticoid activity
2. Insignificant mineralcorticoid activity
3. Long duration of action. ``

Question 5

What activity does Deflazacort have?

What is it derived from?

Answer 5

Deflazacort has a high glucocorticoid activity; it is derived from prednisolone.