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Pharmacology > Endocrine Meds: corticosteroids > Flashcards

Endocrine Meds: corticosteroids Flashcards

1
Q

List the organs involved in the endocrine system

A

Hypothalamus
Pituitary gland
Thyroid
Parathyroid
Adrenal gland
Pancreas
Gonads etc.

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2
Q

Identify which gland receives sensory messages from the nervous system and communicates with the endocrine system

A

Hypothalamus

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3
Q

Recall the hormones the anterior pituitary gland produces (6)

A

Growth hormone
Prolactin
Thyrotropin (TSH)
Corticotropin (ACTH)\
LH
FSH

Like a football!

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4
Q

Describe corticosteroids and the function

A

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

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5
Q

Describe the 3 steps of corticosteroids production

A
  1. Corticotropin-Releasing Hormone (CRH) by hypothalamus
  2. Adrenocorticotropic hormone (ACTH) by anterior pituitary

**aka corticotropin

  1. Cortisol & Aldosterone by adrenal cortex
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6
Q

List the functions of cortisol. Which function is therapeutically most significant?

A
  • controls carbs, fat, and protein metabolism
  • suppress inflammation !!!
  • prevents phospholipid release
  • decreases eosinophil action
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7
Q

What is the most significant risk with corticosteroid therapy

A

Adrenal Gland Suppression

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8
Q

Explain the pathophysiology behind adrenal gland suppression

A

CRH and ACTH suppressed
–> adrenal cortex also suppressed (becomes sleepy)
–> prolonged suppression can lead to gland atrophy, the recovery can take months

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9
Q

List the classic risk factors for adrenal gland suppression

A

High doses of steroids for more than a week may cause adrenal gland suppression

Corticosteroid therapy should be weaned off gradually!

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10
Q

List some of the conditions treated with corticosteroids

A

Joint pain, inflammation
Arthritis
Dermatitis
Allergic rxn, asthma
Hepatitis
Lupus
Glucocorticoid replacement in Addison’s disease

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11
Q

Examples of corticosteroids

A

Hydrocortisone (cortisol)
Prednisone
Prednisolone
Methylprednisolone (Medrol)
Betamethasone
Dexamethasone ***high glucocorticoid potency, little mineralocorticoid potency

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12
Q

Recall the different between Cushing syndrome & disease

A

Excess corticosteroids can be caused by corticosteroid use (Cushing syndrome) or endocrine imbalance like Cushing Disease.

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13
Q

Identify the hormone in excess in Cushing’s disease and Cushing’s syndrome

A
  1. ACTH
  2. Cortisol
  3. Aldosterone
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14
Q

**systemic effects of excess corticosteroids

Effects on CNS & face

A

Mood swings
Moon face
Hirsutism (lady beard, facial hair)
Buffalo hump (bump @ back of the neck)

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15
Q

**systemic effects of excess corticosteroids

Cardiovascular effect

A

Hypertension

Na up, K down

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16
Q

**systemic effects of excess corticosteroids

Recall how corticosteroids can create a risk for digoxin toxicity in a patient on digoxin

A

Low potassium (due to excess aldosterone) puts patient at risk for digoxin toxicity

17
Q

**systemic effects of excess corticosteroids

Effects on abdomen & kidneys

A

Fat accumulation around belly

Increased serum glucose, insulin resistance

18
Q

**systemic effects of excess corticosteroids

Sexual effects

A

decreased libido
impotence
amenorrhea
infertility

19
Q

**systemic effects of excess corticosteroids

Effects on skin and bone

A

Acne
Muscle atrophy (muscle wasting)
Excessive sweating
Purple striae
Pt bruises easily (“steroid skin”)

Suppresses growth in children
Difficult on bones

20
Q

Define Addison’s disease

A

Addison’s disease means “adrenal insufficiency”

Adrenal hormones (cortisol, aldosterone, and adrenaline) are insufficient

21
Q

Recall the causes of Addison’s disease

A

Two causes
1. adrenal gland malfunction (adrenal gland destroyed by autoimmune process)

  1. anterior pituitary deficit (does not produce enough ACTH)
22
Q

What is a condition caused by steroid use and being similar to Addison’s disease?

A

Adrenal gland suppression (pt on high dose of corticosteroids and did not wean gradually)

23
Q

**systemic effects of adrenal insufficiency

CNS effects

A

chronic fatigue

24
Q

**systemic effects of adrenal insufficiency

Cardiovascular effects

A

Dehydration, low BP, tachycardia

craving salty foods

25
Q

**systemic effects of adrenal insufficiency

GI effects

A

Nausea, vomiting
Diarrhea (already dehydrated!)
Hypoglycemia

26
Q

Recall the factors that contribute to developing an Addisonian crisis

A

This is most often caused by sudden withdrawal of corticosteroid therapy

27
Q

Explain how to treat a patient in Addisonian crisis

A

First and foremost, give them corticosteroids!

We can also give then fluids & sugars.

Pharmacology (20 decks)

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