glucocorticoids Flashcards
where are glucocorticoids produced
zona fasculata of adrenal cortex
mechanism of action of GCs
- v lipophilic - can penetrate cell membrane
- in nucleus they influence transcription of genes coding inflammatory proteins
GCs effect on gluconeogenesis
incr GNG - hyperglyceamia
-proteins and fats -> GNG
how do GCs cause osteoporosis
decr Ca absorption, incorporation
how do GCs cause delayed wound healing
decr collagen synthesis - dont use during or after surgery
why shouldnt we use GCs for animals under 1 yr
can cause decr growth
other pathological effects of GCs
- muscle atrophy, weakness
- skin thinning, alopecia
- decr growth
- polyuria, polydypsea
pharmacological effects of GCs
- antiinflammatory
- antiallergic
- immunosuppressive
- antishock
- neuroprotective
what do they do to COX enzyme expression
decr
what do they do to interleukin expression
decr
what happens to TNF and IFN synthesis
decr
why are GCs useful in the treatment of leukemias and lymphomas
apoptosis in lymphocytes - lymphocytopenia
what do they do to neutrophils
mobilise them - demargination
what do they do to capillary membrane permeability
decr -? enhancing microcirculation
what do high dosages of GCs do to blood vessels
vasoconstriction
neuroprotective effects of GCs
they counteract lipid peroxidation and enhance microcirculation
active substances
- Na phosphate
- Na succinate
- dipropionate
- diphenylproprionate
- acetate
- acetonide
side effects
- HT-HP-adrenal cortex axis inhibiton
- gastric ulcers
- hepatopathy
- pancreatitis
- glaucoma, cataracts
- thinning of skin
- polyuria/polydypsea
- polyphagia
- remobilising fats
- muscle atrophy
- immunosuppression
what does long term usage do to the adrenal cortex
it atrophies
signs of hepatopathy after GCs
ALKP significant incr
how do we counteract hepatopathy
hepatoprotectives
how do we counteract gastric ulcers
gastroprotectives
is pancreatitis a common side effect of GCs
no its quite rare
types of systemic usage of GCs
- high dosage once
- ADT
- long acting inj
what does ADT stand for
alternate day therapy
what drugs can we use ADT for
prednisolone, methylprednisolone
how often do we administer for ADT
every other day
when do we do ADT in dogs
mornings
when do we do ADT in cats
evenings
when should we use long acting injections, or depot
only if ADT not avaliable
recommended order of usage of GCs
- local usage
- single inj dose
- asthama, RAO
- intrarticular
- ADT
- depot inj
