Glucocoritcoids (63,76) Flashcards by Ella Thorsteinson

Arden gland consists of

Cortex and medulla

How well did you know this?

Not at all

Perfectly

Cortex vs medulla

Cortex: secretes glucocorticoids and mineralcorticoids

Medulla: epinephrine and NE

How well did you know this?

Not at all

Perfectly

Anterior pituitary ACTH stimulates

Glucocorticoid release
-mainly cortisol from cortex

How well did you know this?

Not at all

Perfectly

Process of cortisol stimulation/secretion

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

How well did you know this?

Not at all

Perfectly

Glucocorticoids promote

Glucose availability
-gluconeogeneiss, inhibit glucose usage etc

How well did you know this?

Not at all

Perfectly

Glucocorticoids metabolize…

Proteins, fat (including redistribution)

How well did you know this?

Not at all

Perfectly

Glucocorticoids impact on cardiovascular system

Supports SNS activity on blood vessels

How well did you know this?

Not at all

Perfectly

Over secretion of adrenocortical hormones leads to

Cushing syndrome

How well did you know this?

Not at all

Perfectly

Under secretion of adrenocorticoial hormones leads to

Addison disease

How well did you know this?

Not at all

Perfectly

Glucocorticoids example

Prednisone

How well did you know this?

Not at all

Perfectly

Prednisone

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

How well did you know this?

Not at all

Perfectly

Glucocorticoids administered via + indication per

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

How well did you know this?

Not at all

Perfectly

MOA Glucocorticoids

Alter gene expression of many proteins

How well did you know this?

Not at all

Perfectly

Glucocorticoids help to control

Inflammatory and immune responses

How well did you know this?

Not at all

Perfectly

Glucocorticoids have a wide variety of _____

Indications

How well did you know this?

Not at all

Perfectly

Glucocorticoids indications (5)

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

How well did you know this?

Not at all

Perfectly

Glucocorticoids + adrenocortical deficiency

Lifelong replacement therapy

How well did you know this?

Not at all

Perfectly

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

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

Contraindications of Glucocorticoids

Serious infections
-eg: fungal infections

Use Glucocorticoids cautiously in patients with (7)

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

Why be cautious of Glucocorticoids with diabetes mellitus

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

CV cautions with Glucocorticoids

Hypertension and heart failure

Glucocorticoids mimic (this is an AE)

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

AE of Glucocorticoids

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

AE of Glucocorticoids: cardiovascular

heart failure, cardiac edema, hypertension WHY: electrolyte imbalances, and an enhanced SNS

AE of Glucocorticoids: CNS

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

AE of Glucocorticoids: endocrine

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

AE of Glucocorticoids: GI

PUD + perforation, pancreatitis, abdominal distension

AE of Glucocorticoids: integumentary

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

AE of Glucocorticoids: musculoskeletal

Muscle weakness, loss of muscle mass, osteoporosis

AE of Glucocorticoids: ocular

Increased intraocular pressure and glaucoma

AE of Glucocorticoids: other

Weight gain

Glucocorticoids: replacement therapy does not produce

Cushing’s syndrome

When are major AE more common when taking Glucocorticoids

During inflammation suppression or immune suppression

Glucocorticoids replacement therapy may need

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

What is the 3 by 3 rule in Glucocorticoids replacement therapy

Take 3 times the usual dose for 3 days

Adrenal suppression: immunosuppressant therapy

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

Cortex atrophy in immunosuppressant therapy

Tapering of doses to allow adrenal cortex to recover

Sudden discontinuation of Glucocorticoids

Can precipitate an adrenal crisis -adrenal incapacity to synthesis glucocorticoids

Symptoms of adrenal crisis

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

Doses of Glucocorticoids usually are

Tapered before the drug is discontinued

What should patients be taught about taking adrenal medications?

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

Caution taking ___ while on adrenal medications and why?

NSAIDs use -risk of stomach ulcers

Patients on Glucocorticoids should avoid

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