Endocrine Meds: corticosteroids Flashcards
List the organs involved in the endocrine system
Hypothalamus
Pituitary gland
Thyroid
Parathyroid
Adrenal gland
Pancreas
Gonads etc.
Identify which gland receives sensory messages from the nervous system and communicates with the endocrine system
Hypothalamus
Recall the hormones the anterior pituitary gland produces (6)
Growth hormone
Prolactin
Thyrotropin (TSH)
Corticotropin (ACTH)\
LH
FSH
Like a football!
Describe corticosteroids and the function
any of a group of steroid hormones produced in the adrenal cortex or made synthetically. There are two kinds:
glucocorticoids–> body’s response to stress
mineralocorticoids –> aldosterone
Describe the 3 steps of corticosteroids production
- Corticotropin-Releasing Hormone (CRH) by hypothalamus
- Adrenocorticotropic hormone (ACTH) by anterior pituitary
**aka corticotropin
- Cortisol & Aldosterone by adrenal cortex
List the functions of cortisol. Which function is therapeutically most significant?
- controls carbs, fat, and protein metabolism
- suppress inflammation !!!
- prevents phospholipid release
- decreases eosinophil action
What is the most significant risk with corticosteroid therapy
Adrenal Gland Suppression
Explain the pathophysiology behind adrenal gland suppression
CRH and ACTH suppressed
–> adrenal cortex also suppressed (becomes sleepy)
–> prolonged suppression can lead to gland atrophy, the recovery can take months
List the classic risk factors for adrenal gland suppression
High doses of steroids for more than a week may cause adrenal gland suppression
Corticosteroid therapy should be weaned off gradually!
List some of the conditions treated with corticosteroids
Joint pain, inflammation
Arthritis
Dermatitis
Allergic rxn, asthma
Hepatitis
Lupus
Glucocorticoid replacement in Addison’s disease
Examples of corticosteroids
Hydrocortisone (cortisol)
Prednisone
Prednisolone
Methylprednisolone (Medrol)
Betamethasone
Dexamethasone ***high glucocorticoid potency, little mineralocorticoid potency
Recall the different between Cushing syndrome & disease
Excess corticosteroids can be caused by corticosteroid use (Cushing syndrome) or endocrine imbalance like Cushing Disease.
Identify the hormone in excess in Cushing’s disease and Cushing’s syndrome
- ACTH
- Cortisol
- Aldosterone
**systemic effects of excess corticosteroids
Effects on CNS & face
Mood swings
Moon face
Hirsutism (lady beard, facial hair)
Buffalo hump (bump @ back of the neck)
**systemic effects of excess corticosteroids
Cardiovascular effect
Hypertension
Na up, K down
**systemic effects of excess corticosteroids
Recall how corticosteroids can create a risk for digoxin toxicity in a patient on digoxin
Low potassium (due to excess aldosterone) puts patient at risk for digoxin toxicity
**systemic effects of excess corticosteroids
Effects on abdomen & kidneys
Fat accumulation around belly
Increased serum glucose, insulin resistance
**systemic effects of excess corticosteroids
Sexual effects
decreased libido
impotence
amenorrhea
infertility
**systemic effects of excess corticosteroids
Effects on skin and bone
Acne
Muscle atrophy (muscle wasting)
Excessive sweating
Purple striae
Pt bruises easily (“steroid skin”)
Suppresses growth in children
Difficult on bones
Define Addison’s disease
Addison’s disease means “adrenal insufficiency”
Adrenal hormones (cortisol, aldosterone, and adrenaline) are insufficient
Recall the causes of Addison’s disease
Two causes
1. adrenal gland malfunction (adrenal gland destroyed by autoimmune process)
- anterior pituitary deficit (does not produce enough ACTH)
What is a condition caused by steroid use and being similar to Addison’s disease?
Adrenal gland suppression (pt on high dose of corticosteroids and did not wean gradually)
**systemic effects of adrenal insufficiency
CNS effects
chronic fatigue
**systemic effects of adrenal insufficiency
Cardiovascular effects
Dehydration, low BP, tachycardia
craving salty foods
