Glucocorticoid Drugs Flashcards
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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
Systemic lupus erythematosus treatment by Glucocorticoids/corticosteroids
Severe episodes can be managed with aggressive administration
IBS and crohn’s treatment by Glucocorticoids/corticosteroids
Administration via oral or enema may help bring relief
DOC for life threatening allergic reactions is…
Why isn’t it glucocorticoids?
Epi, because the response is delayed they cannot serve acute allergic rxns
Most effective treatment for asthma and what is the best way to administer it?
Glucocorticoids/corticosteroids, Inhalation
Dermatologic disorders treated by Glucocorticoids/corticosteroids (4)
- Psoriasis
- mycoses
- seborrhea
- contact dermatitis
Glucocorticoids ADR’s (8)
- 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
Glucocorticoids/corticosteroids effect on pregnancy and lactation
- prolonged high dose therapy can cause fetal adrenal hyperplasia
- Breast feeding risk of transfer to infant
Glucocorticoids/corticosteroids drug interactions
- Insulin and oral hypoglycemics make glucocorticoids require a higher dosage
- vaccines should not be given, especially live ones
- NSAIDS increase risk of peptic ulceration
Cardiovascular effects of Glucocorticoids/corticosteroids
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
List a common glucocorticoid inhaler used as effective treatment of asthma
Pulmicort (budesonide)
Neoplasms of ___ origin can be effeectively treated in conjunction with other anticancer agents by ___
lymphatic tissue, glucocorticoids
