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Pharmacology > Glucocoritcoids (63,76) > Flashcards

Glucocoritcoids (63,76) Flashcards

1
Q

Arden gland consists of

A

Cortex and medulla

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2
Q

Cortex vs medulla

A

Cortex: secretes glucocorticoids and mineralcorticoids

Medulla: epinephrine and NE

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3
Q

Anterior pituitary ACTH stimulates

A

Glucocorticoid release
-mainly cortisol from cortex

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4
Q

Process of cortisol stimulation/secretion

A

-stress/circadian rhythm
-hypothalamus
-CRH
-anterior pituitary
-ACTH
-adrenal cortex
-Cortisol

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5
Q

Glucocorticoids promote

A

Glucose availability
-gluconeogeneiss, inhibit glucose usage etc

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6
Q

Glucocorticoids metabolize…

A

Proteins, fat (including redistribution)

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7
Q

Glucocorticoids impact on cardiovascular system

A

Supports SNS activity on blood vessels

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8
Q

Over secretion of adrenocortical hormones leads to

A

Cushing syndrome

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9
Q

Under secretion of adrenocorticoial hormones leads to

A

Addison disease

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10
Q

Glucocorticoids example

A

Prednisone

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11
Q

Prednisone

A

Drug of choice for oral glucocorticoids + anti-inflammatory purposes, hormone replacement

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12
Q

Glucocorticoids administered via + indication per

A

-inhalation (asthma, COPD)
-nasally (rhinitis, prevention of polyps after surgical removal)
-topically (inflammation of eye, ear, skin)
-systemic, IV/PO (hormone replacement and immunosuppression)

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13
Q

MOA Glucocorticoids

A

Alter gene expression of many proteins

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14
Q

Glucocorticoids help to control

A

Inflammatory and immune responses

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15
Q

Glucocorticoids have a wide variety of _____

A

Indications

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16
Q

Glucocorticoids indications (5)

A

-adrenocortical deficiency
-anti-inflammatory/immune suppression
-leukaemia/lymphomas
-spinal cord injury
-cerebral edema

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17
Q

Glucocorticoids + adrenocortical deficiency

A

Lifelong replacement therapy

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18
Q

(4) examples of anti-inflammatory/immune suppression indications of Glucocorticoids

A

-chronic respiratory illnesses (asthma/COPD)
-organ transplant
-dermatological diseases
-GI disease

19
Q

Contraindications of Glucocorticoids

A

Serious infections
-eg: fungal infections

20
Q

Use Glucocorticoids cautiously in patients with (7)

A

-gastritis, reflux disease, PUD
-DM
-CV
-renal impairment
-pregnancy

21
Q

Why be cautious of Glucocorticoids with diabetes mellitus

A

Risk of leading to hyperglycemia
-as Glucocorticoids increase plasma glucose levels

22
Q

CV cautions with Glucocorticoids

A

Hypertension and heart failure

23
Q

Glucocorticoids mimic (this is an AE)

A

Cushing syndrome
-moon face, buffalo hump, abdominal fat, thin arms and legs, stria

24
Q

AE of Glucocorticoids

A

-CV
-CNS
-endocrine
-GI
-integumentary
-musculoskeletal
-ocular
-other

25
Q

AE of Glucocorticoids: cardiovascular

A

heart failure, cardiac edema, hypertension

WHY: electrolyte imbalances, and an enhanced SNS

26
Q

AE of Glucocorticoids: CNS

A

Convulsions, headache, vertigo, mood swings, nervousness, insomnia, steroid psychosis

27
Q

AE of Glucocorticoids: endocrine

A

Growth suppression, Cushing syndrome, menstral irregularities, carbohydrate intolerance, hyperglycemia

28
Q

AE of Glucocorticoids: GI

A

PUD + perforation, pancreatitis, abdominal distension

29
Q

AE of Glucocorticoids: integumentary

A

Fragile skin, petechiae, ecchymoses, facial erythema, poor wound healing, hair suit isn, urticaria

30
Q

AE of Glucocorticoids: musculoskeletal

A

Muscle weakness, loss of muscle mass, osteoporosis

31
Q

AE of Glucocorticoids: ocular

A

Increased intraocular pressure and glaucoma

32
Q

AE of Glucocorticoids: other

A

Weight gain

33
Q

Glucocorticoids: replacement therapy does not produce

A

Cushing’s syndrome

34
Q

When are major AE more common when taking Glucocorticoids

A

During inflammation suppression or immune suppression

35
Q

Glucocorticoids replacement therapy may need

A

An increase in dosage during times of stress
-eg: infections, surgery, other traumas

36
Q

What is the 3 by 3 rule in Glucocorticoids replacement therapy

A

Take 3 times the usual dose for 3 days

37
Q

Adrenal suppression: immunosuppressant therapy

A

Drug inhibits physiological control of cortisol secretion
-reduced or absent ACTH

38
Q

Cortex atrophy in immunosuppressant therapy

A

Tapering of doses to allow adrenal cortex to recover

39
Q

Sudden discontinuation of Glucocorticoids

A

Can precipitate an adrenal crisis
-adrenal incapacity to synthesis glucocorticoids

40
Q

Symptoms of adrenal crisis

A

-abdominal pain
-low BP, dehydration = syncope + dizziness
-shock (fatal)
-extreme fatigue
-confusion and convulsions

41
Q

Doses of Glucocorticoids usually are

A

Tapered before the drug is discontinued

42
Q

What should patients be taught about taking adrenal medications?

A

All adrenal medications should be taken at the same time every day (morning) with food

43
Q

Caution taking ___ while on adrenal medications and why?

A

NSAIDs use
-risk of stomach ulcers

44
Q

Patients on Glucocorticoids should avoid

A

Contact with people with infections
-report any fever, increased weakness, lethargy or sore throat

Pharmacology (37 decks)

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