Glucocorticoids

Question 1

What time is plasma glucocorticoids high and reaches its peak and which time it returns to basal level

Answer 1

• Rises high from 2 AM reaches its speak in the early morning 6 to 8 hours and return to Basal level at 12 PM

Question 2

classify glucocorticoids, based on the derivatives

Answer 2

Semisynthetic
Fluorinated

Question 3

Mention the semi synthetic glucocorticoids

Answer 3

*prednisone,prednislone
*methyl prednisone
*Dexamethasone
*Betamethasone

Question 4

Mention the fluorinated glucocorticoids

Answer 4

*Dexamethasone
*Betamethasone
*Triamsinolone

Question 5

Classification of glucorticoids based on duration of action

Answer 5

*short acting (8-12hrs)
Hydrocortisone and cortisone
*medium duration of action (18-36hrs)
Prednisone,methyl prednisone and prednisolone
* Long acting duration of action (36. -54 hrs)
-Dexamethasone
-Betamethasone
-Triamcinolone

Question 6

Mechanism of action of corticosteroids

Answer 6

*genomic
*Non genomic

Question 7

Describe genomic mechanisms of action of glucocorticoids

Answer 7

Glucocorticoids bind with heat shock proteins intracellular after conformational change then it moves into the DNA and begins transcription of certain genes which then leads protein mRNA synthesis of Annexin which responsible for inhibiting pro inflammatory proteins and enzymes like Cox2, T-helpers cells etc

Question 8

Actions of Annexin A1

Answer 8

*Antipyretic(anti fever
*Antiinflammatory
*inhibit production of cytokines

Question 9

Describe non genomic mechanisms of action

Answer 9

*It is membrane bound mechanism some glucocorticoids are more effective on membrane example methyl prednisolone is 3 times more stronger than prednisolone

Question 10

Pharmacological effects of corticosteroids

Answer 10

*Antishock
*Anti-inflammatory
*immunosuppressive

Question 11

Mention the metabolic effects of glucocorticoids on carbohydrate,protein,fats water and salt in the body

Answer 11

• Carbohydrates: It increases glycogen storage in the liver, and it also leads to release of glucose in blood which can lead to hyperglycemia and is contraindicated with patients with diabetes
• Proteins: It leads to break down of proteins in the body , catabolism in particular, and that will lead muscle wasting
• Fat: It’s leads to an even distribution of fat around the body, which is known as Cushingnoid syndrome Appearance include moonface “buffalo hump
• Salt and water metabolism: Glucocorticoids retains water and salt in the body Which will build up and cause hypertension

Question 12

Effects of glucocorticoids on calcium metabolism

Answer 12

calcium metabolism It’s inhibits the absorption of calcium from the intestine, and also stimulates the release of calcium from the bonus, which will lead to secondary hyperparathyroidism Parathyroid hormone is responsible for maintenance of calcium level in blood, but due to this effect of glucocorticoids, it leads to osteoporosis

Question 13

Side effects of glucocorticoids

Answer 13

• Risks of infection
• Hypertension
• Cushingoid syndrome
• Hyper lipidemia
• Diabetes hyperglycemia
• Osteoporosis
• Muscle wasting (myopathy)

Question 14

5 Contraindications of glucocorticoids

Answer 14

Immunocompromise patients
Diabetes
Osteoporosis
Pancreatitis and obesity
Arterial, hypertension,
Mental illness or epilepsy

Question 15

Indications of glucocorticoids

Answer 15

Replacement therapy with hydrocortisone
Antishock, anti-inflammatory action for patients with autoimmune diseases
This includes in rheumatology, gastroenterology, pulmonology, ophthalmology, endocrinology, and all these include all the diseases such as a rheumatology.leukemia ,gastroenterology inflammatory bowel disease in pulmonology you have bronchial asthma,

Question 16

Name respiratory glucocorticoids 2

Answer 16

Fluticasone
Budesonide

Question 17

Pharmacokinetics of glucocorticoids

Answer 17

• System of glucocorticoids bind transcortin(80%), and albumin (10%) and eliminated through the kidneys

Question 18

Explain alternative day therapy of glucocorticoids

Answer 18

This involves giving glucocorticoids for two days then you stop , give 2 days in between or three days in between and give glucocorticoids again then another two days of rest this helps to prevent withdrawal

Question 19

Explain intermittent therapy of glucocorticoids

Answer 19

Short courses of administration of glucocorticoids 2-3 day then wait after 3-4 days before administering glucocorticoids again

Question 20

Pulse therapy

Answer 20

Short term administration of high doses glucocorticoids drug of choice is methyl prednisolone to prevent side effects