Glucocorticoid Drugs Flashcards
help
Glucocorticoids/corticosteroids effect at low volumes
Physiologic effects, carbohydrate metabolism raises blood glucose levels, unfavorable effect on protein metabolism (neg nitrogen balance), stimulation of fat breakdown and also fat redistribution (cushings), often done to treat endocrine disorders
Glucocorticoids/corticosteroids effect at high volumes
Suppress inflammation, certain cancers, and immune system at higher doses
Glucocorticoids/corticosteroids toxicity
Non toxic at physiologic doses or acute high dosage, but if high dose chronically can see severe toxicity
2 examples of Glucocorticoids/corticosteroids
prednisone, cortisone
Stress effects of Glucocorticoids/corticosteroids
Surge in glucocorticoids in response to stress, absence in sufficient amounts results in hypotension, hypoglycemia, and circulatory failure
Water and electrolyte effects of Glucocorticoids/corticosteroids
Glucocorticoids to varying degrees act like aldosterone to act on kidney promoting retention of sodium and water resulting in hypernatremia, edema, and hypokalemia
Respiratory effects of Glucocorticoids/corticosteroids
In a pre term infant, low corticosteroid production results in increased incidence of respiratory distress syndrome because it is required during delivery to stimulate lung maturation
Glucocorticoids/corticosteroids release mech
- stress acts on hypothalamus
- hypothalamus releases CRF
- Ant pit receives CRF and releases ACTH
- The adrenal cortex receives ACTH and causes release of glucocorticoids that has neg feedback on hypothalamus and ant pituitary
Glucocorticoids/corticosteroids mech of action at cellular levels
- Bind to intracellular receptors blocking RNA synthesis
- Directly modulate protein production by allowing RNA synthesis
Anti inflammatory effects of Glucocorticoids/corticosteroids
Prevent the symptoms of inflammation, warmth redness and swelling and tenderness
NSAIDS act on ___ enzyme to prevent ___ formation
cyclooxygenase, prostacyclins
Glucocorticoids/corticosteroids act on ___ enzyme to prevent ___ formation, and are thus ___ than NSAIDS
arachodonic acid formation (delta 6 desaturator), leukotrienes and prostacyclins downstream, stronger
Glucocorticoids/corticosteroids immunosuppresive function (2)
- IL1 activation
- chemotaxis inhibition
High dose Glucocorticoids/corticosteroids treat ___
non endocrine disorders
RA treatment by Glucocorticoids/corticosteroids
Reduces inflammation and pain, but does not alter course of disease, prolonged systemic use should be avoided