Glucocorticoid Drugs Flashcards

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1
Q

Glucocorticoids/corticosteroids effect at low volumes

A

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

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2
Q

Glucocorticoids/corticosteroids effect at high volumes

A

Suppress inflammation, certain cancers, and immune system at higher doses

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3
Q

Glucocorticoids/corticosteroids toxicity

A

Non toxic at physiologic doses or acute high dosage, but if high dose chronically can see severe toxicity

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4
Q

2 examples of Glucocorticoids/corticosteroids

A

prednisone, cortisone

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5
Q

Stress effects of Glucocorticoids/corticosteroids

A

Surge in glucocorticoids in response to stress, absence in sufficient amounts results in hypotension, hypoglycemia, and circulatory failure

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6
Q

Water and electrolyte effects of Glucocorticoids/corticosteroids

A

Glucocorticoids to varying degrees act like aldosterone to act on kidney promoting retention of sodium and water resulting in hypernatremia, edema, and hypokalemia

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7
Q

Respiratory effects of Glucocorticoids/corticosteroids

A

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

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8
Q

Glucocorticoids/corticosteroids release mech

A
  • 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
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9
Q

Glucocorticoids/corticosteroids mech of action at cellular levels

A
  • Bind to intracellular receptors blocking RNA synthesis

- Directly modulate protein production by allowing RNA synthesis

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10
Q

Anti inflammatory effects of Glucocorticoids/corticosteroids

A

Prevent the symptoms of inflammation, warmth redness and swelling and tenderness

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11
Q

NSAIDS act on ___ enzyme to prevent ___ formation

A

cyclooxygenase, prostacyclins

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12
Q

Glucocorticoids/corticosteroids act on ___ enzyme to prevent ___ formation, and are thus ___ than NSAIDS

A

arachodonic acid formation (delta 6 desaturator), leukotrienes and prostacyclins downstream, stronger

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13
Q

Glucocorticoids/corticosteroids immunosuppresive function (2)

A
  • IL1 activation

- chemotaxis inhibition

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14
Q

High dose Glucocorticoids/corticosteroids treat ___

A

non endocrine disorders

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15
Q

RA treatment by Glucocorticoids/corticosteroids

A

Reduces inflammation and pain, but does not alter course of disease, prolonged systemic use should be avoided

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16
Q

Systemic lupus erythematosus treatment by Glucocorticoids/corticosteroids

A

Severe episodes can be managed with aggressive administration

17
Q

IBS and crohn’s treatment by Glucocorticoids/corticosteroids

A

Administration via oral or enema may help bring relief

18
Q

DOC for life threatening allergic reactions is…

Why isn’t it glucocorticoids?

A

Epi, because the response is delayed they cannot serve acute allergic rxns

19
Q

Most effective treatment for asthma and what is the best way to administer it?

A

Glucocorticoids/corticosteroids, Inhalation

20
Q

Dermatologic disorders treated by Glucocorticoids/corticosteroids (4)

A
  • Psoriasis
  • mycoses
  • seborrhea
  • contact dermatitis
21
Q

Glucocorticoids ADR’s (8)

A
  • Usually not seen in physiologic or brief treatment
  • Adrenal insufficiency due to suppression of cortex and potential atrophy
  • Risk of new infection or reactivation of latent infection via immune suppression
  • Decreased production of cytoprotective prostaglandins that produce mucus and inhibit acid production in the stomach resulting in peptic ulcer
  • prolonged use increased risk of osteoperosis
  • Mental disorders
  • cataracts and glaucoma
  • Delayed growth in children
  • Nose dryness
22
Q

Glucocorticoids/corticosteroids effect on pregnancy and lactation

A
  • prolonged high dose therapy can cause fetal adrenal hyperplasia
  • Breast feeding risk of transfer to infant
23
Q

Glucocorticoids/corticosteroids drug interactions

A
  • Insulin and oral hypoglycemics make glucocorticoids require a higher dosage
  • vaccines should not be given, especially live ones
  • NSAIDS increase risk of peptic ulceration
24
Q

Cardiovascular effects of Glucocorticoids/corticosteroids

A

Required to maintain functional integrity of vascular system, low levels cause increased capillary permeability and vasodilation, increase in RBC count and decrease in WBC count

25
Q

List a common glucocorticoid inhaler used as effective treatment of asthma

A

Pulmicort (budesonide)

26
Q

Neoplasms of ___ origin can be effeectively treated in conjunction with other anticancer agents by ___

A

lymphatic tissue, glucocorticoids