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Pharmacology > Glucocorticoids > Flashcards

Glucocorticoids Flashcards

1
Q

What is inflammation ?

A

Defensive response in order to isolate and eliminate the cause of injury

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2
Q

Hormones of adrenal cortex of the adrenal glands

A
  1. Glucocorticosteroids
  2. Mineralocorticosteroids
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3
Q

Generally what do glucocorticosteroids do?

A

Impact the metabolism of proteins, lipids, carbohydrates and have an antiinflammatory effect

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4
Q

Generally what do mineralocorticosteroids do?

A

Impact the metabolism of water and electrolytes

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5
Q

Natural sources of glucocorticosteroids

A

Cortisone
Hydrocortisone

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6
Q

Synthetic sources of glucocorticosteroids

A

Predinosolone
Dexamethasome
Triamcinolone
Flumethasone

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7
Q

Effects of glucocorticosteroids

A
  1. Increased gluconeogenesis
  2. Antagonism of insulin
  3. Increased catabolism of proteins
  4. Fatty degeneration
  5. Stimulate protein & RNA synthesis in
    liver
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8
Q

General effects of glucocorticosteroids

A
  1. Stabilisation of cell membranes
  2. Reduction of exudation
  3. Number of eosinophils & lymphocytes
    is reduced
  4. Phagocytosis capacity is weakened
  5. Immunosuppressive and antiallergic
    effect
  6. Potentiate the action of parathyroid
    hormone and inhibit the gut
    absorption of Ca
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9
Q

Pharmacokinetics of glucocorticosteroids

A
  1. Absorb well, duration of effect depends on drug
  2. Natural steroids are short acting
  3. In blood, partially bound to blood
    proteins - free fraction achieves the
    effect
  4. Metabolised in liver
  5. 75% excreted in urine, 25% in feces
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10
Q

Pharmacodynamics of glucocorticosteroids

A

Effect is to large extent based on inhibition of protein, including enzyme protein synthesis and deceleration of proliferation of cells
- Steroids are fat soluble, with low
molecular weight and diffuse easily
into the cells

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11
Q

Metabolic effects of glucocorticosteroids

A
  1. Cause catabolism - which leads to
    negative nitrogen balance (large
    amount of nitrogen & uric acid is
    secreted into urine)
  2. Anabolism is impeded - growth
    disturbance occurs, wounds heal
    badly.
    -Animals become weakened and
    passive
  3. Inhibit breaking down of glucose
    Hyperglycemia and glycosuria
    experienced in case of overdose
  4. Fatty degeneration - deposits of fat
    on stomach, back and face (cushings)
  5. Large doses cause edema,
    hypokalemia and metabolic alkalosis
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12
Q

Anti-inflammatory effect of glucocorticosteroids

A
  1. Suppress reaction of tissue to the
    factors
  2. Classic features of inflammation
    disappear
  3. Due to decreased permeability of
    blood vessels - edemas will disappear.
  4. Inhibit the normal response of an
    organism to stimuli
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13
Q

Effects of glucocorticosteroids on skeletal muscle system

A
  1. Muscles will be weakened after long-
    term administration due to result of
    decreased potassium quantities
  2. Excretion of Ca, phosphorus and
    nitrogen has also increased - loss of
    Ca from bones
  3. Muscle mass is reduced.
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14
Q

Effects of glucocorticosteroids on endocrine system

A

If administered for long time in large doses: decrease in synthesis of adrenocorticotropic hormone may occur
-> Long term treatment must be
concluded by reducing doses step-by-
step

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15
Q

Effect of glucocorticosteroids on immune system

A

Inhibition.
- This effect is used to suppress the
rejection reaction after an organ
transplant

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16
Q

Cardiorespiratory effect of glucocorticosteroids

A
  1. Direct positive inotropic and
    chronotropic effect on heart
  2. Vasoconstriction if injected IN blood
    vessels
  3. May cause hypertension
  4. Increase number and affinity of Beta
    adrenergic receptors
    5.Increase potency of effect of beta-
    adrenergic substances on smooth
    muscle of bronchi
17
Q

Dermatologic effects of glucocorticosteroids

A
  1. Reduce collagen synthesis - reduced
    wound healing
  2. Skin becomes thin
  3. Dogs may develop bilateral
    symmetrical alopecia
18
Q

Reproductive effects of glucocorticosteroids

A
  1. High doses induce parturition during
    later part of pregnancy in ruminants
    and horses
  2. Generally have teratogenic effects
    during early pregnancy
19
Q

Uses of glucocorticosteroids

A
  1. Ketosis in cattle (glyconeogenesis)
  2. Chronic non-infectious inflammatory
    diseases
  3. Other chronic processes
  4. Strong allergic reactions, anaphylactic
    shock
  5. Autoimmune diseases
  6. Do not treat - but relieve symptoms
  7. Physiological replacement therapy
    (addisons - adrenal insufficiency)
  8. Immunosuppressive therapy
  9. Topical and intralesional usage
  10. Ophthalmic application
20
Q

What should be remembered about glucocorticosteroids and infection (+ antibiotics)

A

If used in case of infections -they could lead the infection spreading across the whole organism
1. They suppress immune system!
2. Microbes are most effective when
there is inflammation
- they replicate and in that stage, they
respond well to antibiotics - but they
are only effective with inflammation. -
- If you take away inflammation,
antibiotics are not as effective (make
antibiotics useless)

21
Q

Contraindications of glucocorticosteroids

A
  1. Pregnant animals (abortion)
  2. Infectious diseases
  3. Diabetes
  4. Osteoporosis
  5. Renal impairment
22
Q

Toxicity and side effects of glucocorticosteroids

A
  1. Endocrine system (adrenal
    insufficiency in case of long-term use)
  2. CNS - behavioral changes
  3. Osteoporosis, muscle atrophy
  4. Pancreatitis, liver function disorders,
    ulceration (inhibit synthesis of
    arachidonic acid)
  5. Impaired wound healing
    6.Bilaterally symmetrical alopecia in ca
    7.Induction of parturition ru + eq
  6. Teratogenic effect at beginning of
    gestation
23
Q

What to remember before starting a glucocorticosteroid treatment

A

To not start glucocorticosteroid treatment before you have a proper diagnosis - since they mask symptoms, and may cause side effects

24
Q

Mineralocorticoids general info

A
  1. Target organ: kidney
  2. Aldosterone is most potent regulator of electrolyte excretion - essential for life
  3. Effects: NA retention, K-excretion
25
Q

What are adrenolytic drugs used for

A

Therapy for hyperadrenocorticism; mainly caused by excess ACTH production by pituitary
Cushing’s
->Adrenal glands are bilaterally
hypertrophied, producing excess
cortisol (ca, fe, eq)

Pharmacology (18 decks)

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