Glucocorticoids Flashcards
Glucocorticoid drugs:
Prednisone, Methylprednisolone (Solumedrol)
2 major clinical applications of glucocorticoids:
- Suppress immune response
2. Inflammation supression
MOA of glucocorticoids:
- Inhibit synthesis of chemical mediators (Prostaglandins, leukotrienes, histamine)
- Suppress infiltration of phagocytes
- Suppress proliferation of lymphocytes (reduce immune component of inflammation)
Inflammation presentation w/ Glucocorticoids
Reduced inflammatory response (swelling, warmth, redness, pain)
Vaccines?
Wait until glucocorticoids are no longer in use
Med conditions treated w/ glucocorticoid treatment (9):
Rheumatoid arthritis, Lupus, tendonitis, nausea/emesis, organ transplant, asthma, cancer, preterm infants, drug allergy
GC Cellular MOA:
bind INSIDE the cell to cytoplasm to modulate the production of regulatory proteins
GC and DM:
GC raise blood sugar (incredibly high)
GC promote the synthesis of glucoses from amino acids, reduce peripheral glucose utilization and and reduce glucose uptake by muscle and adipose tissue
Result of GC with DM
Hyperglycemia in long term GC use
GC causes swelling. Why?
Mineralocorticoid activity –> results in Na and water retention and K loss (watch for hypokalemia)
GC can cause:
Cushing’s syndrome:
Hyperglycemia, F&E imbalance, osteoporosis, muscle weakness, “potbelly”, “moonface”, “buffalo hum”
Signs of Cushings:
-Upper body obesity with thin arms and legs, buffalo hump, red and round face, high blood sugar, high blood pressure, vertigo, blurry vision, acne, female balding, water retention, menstrual irregularities, thin skin and bruising, purple striae (stretch marks), poor wound healing, hirsutism (hairy lip), severe depression, cognitive difficulties
Bone reaction to GC
Osteoporosis; chronic steroid therapy results in bone density loss.
Can occur within weeks.
Other SE of GC:
Weight gain, appetite increase, insomnia, hyperactivity, hallucinations, mania, thinned skin with purpura, capillary fragility (IV sites don’t last long)
What electrolyte are we most concerned about with GC (and lasix) use?
Potassium
