Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

605 Pharmacology > Glucocorticoids > Flashcards

Glucocorticoids Flashcards

1
Q

Hypothalamic Pituitary Adrenal Axis (HPAA)

A

hypothalamus secretes corticotropin releasing hormone (CRH) which stimulates the anterior pituitary to produce adrenocorticotropic hormone (ACTH) which tells the adrenal cortex to release cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cortisol Effect on Hypothalamus and Anterior Pituitary

A

negative feedback loop to decrease release of CRH and ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ACTH effect on Hypothalamus

A

negative feedback loop to decrease release of CRH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 General Effects of Cortisol

A
  1. Physiologic
  2. Pharmacologic
  3. Adverse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When we use glucocorticoids, what effects of cortisol are we targeting?

A

pharmacologic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

4 Systems Affected by Glucocorticoids

A
  1. Renal (Kidney)
  2. Cardiovascular
  3. Immune
  4. Metabolic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Renal Effects of Glucocorticoids

A

increase blood pressure (d/t sodium retention and volume expansion); inhibit ADH release so urine becomes less concentrated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cardiovascular Effects of Glucocorticoids

A

increase blood pressure (d/t increase vasoconstriction), decreases vascular permeability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Immune Effects of Glucocorticoids

A

inhibits phospholipase A2 (PLA2) therefore decreasing prostaglandins, decreases cell-mediated immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Excess Glucocorticoid Effect on Immune System?

A

anti-inflammatory and immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Metabolic Effects of Glucocorticoids

A

increases gluconeogenesis, glycogenolysis, and lipolysis (diabetes risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

2 Major Endogenous Glucocorticoids

A
  1. Cortisol (majority of species)
  2. Corticosterone (a few species)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Are we typically administering endogenous or synthetic steroids?

A

synthetic!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

3 Ways to Classify Pharmacologic Steroids

A
  1. Glucocorticoid Potency
  2. Mineralocorticoid Potency
  3. Duration of Action
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Relationship between Prednisone and PredniSOlone?

A

prednisone is a prodrug of predniSOlone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

We talk about glucocorticoid potency in relation to what drug?

A

Prednisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Short-Acting (<12 hours) Glucocorticoids (2)

A
  1. Cortisone
  2. Hydrocortisone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Intermediate-Acting (12-36 hours) Glucocorticoids (4)

A
  1. Prednisone
  2. PredniSOlone
  3. Methylprednisone
  4. Triamcinolone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Long-Acting (>48 hours) Glucocorticoids (3)

A
  1. Flumethasone
  2. Dexamethasone
  3. Betamethasone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which intermediate-acting glucocorticoid is not mineralocorticoid potent?

A

triamcinolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which glucocorticoids are most mineralocorticoid potent - short or long acting?

A

SHORT (long acting have no mineralocorticoid potency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Glucocorticoid Esters

A

chemical groups that can be added to steroid base to alter onset and/or duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Ester Effect on Onset

A

increases water solubility to hasten absorption, therefore a faster onset

24
Q

Ester Effect on Duration

A

decrease solubility to allow depot formation, then bond must be hydrolyzed to be absorbed, resulting in longer duration

25
Q

4 Pharmacologic Indications for Use of Glucocorticoids

A
  1. Physiologic Replacement
  2. Anti-inflammatory
  3. Anti-neoplastic
  4. Immunosuppressive
26
Q

Dosing Range Effect on Function

A

we use DIFFERENT dosing ranges to have different effects, and they can be highly dependent on the individual patient

27
Q

Physiologic Replacement Dosing Range

A

0.1 - 0.25mg/kg/day [prednisone equivalent]

28
Q

Anti-Inflammatory Dosing Range

A

0.5 - 1 mg/kg/day [prednisone equivalent]

29
Q

Anti-Neoplastic Dosing Range

A

1 - 2 mg/kg/day [prednisone equivalent]

30
Q

Immunosuppressive Dosing Range

A

2 [- 4] mg/kg/day [prednisone equivalent]

31
Q

Does continuing to increase does become more immunosuppressive?

A

no, it has a limit, and generally closer to the lower end of the range

32
Q

Indications for Physiologic Replacement

A

Hypoadrenocorticism (Addisons) or other insufficiency; to prevent hypotension, shock, hypoglycemia, bradycardia (so essentially death, don’t die k)

33
Q

Anti-Inflammatory Indications

A

pruritic ear/skin diseases mainly; prevents PLA2 formation, also prevents histamine release

34
Q

Can you use steroids as an anti-inflammatory medication all willy-nilly?

A

no, please rule out primary infectious cause first as steroids can sometimes make these worse

35
Q

Anti-Neoplastic Indications

A

lround cell tumors (such as lymphoma or MCTs); causes apoptosis of [some] lymphocytes (lympholytic effect)

36
Q

Why do we use steroids with neoplasms?

A

more for quality of life rather than survival, best used in combination with chemotherapy

37
Q

Immunosuppressive Indications

A

for various anemias, cytopenias, opathys, meningitis, whatever; acts by many mechanisms of action, including inhibiting macrophages, poor cell adhesion, T cell apoptosis, etc

38
Q

Which indications require tapering?

A

mainly in immunosuppressive (but depending on practice will taper in other uses as well)

39
Q

Most Common Adverse Effects (in dogs)

A

PU/PD, polyphagia (excessive hunger), weight gain, muscle loss, hair loss

40
Q

Cardiovascular and Renal Adverse Effects

A

PU/PD, hypertension, proteinuria

41
Q

Musculoskeletal Adverse Effects

A

pot-belly, muscle wasting, ligament/tendon weakness, osteoporosis; also laminitis in horses

42
Q

CNS Adverse Effects

A

polyphagia, panting, aggression or other behavior change; also masks disease progression

43
Q

Metabolic Adverse Effects

A

weight gain, diabetes mellitus, iatrogenic Addison’s d/t quick withdrawal

44
Q

just a cool table to look at

A

look at it

45
Q

Cutaneous Adverse Effects

A

hair loss, thin skin, poor wound healing

46
Q

Skin Fragility Syndrome

A

in cats, skin tearing, yikes

47
Q

Gastrointestinal Adverse Effects

A

gastritis and ulceration WHEN USED IN COMBINATION with other drugs like NSAIDs (generally not a problem on their own)

48
Q

Calcinosis Cutis

A

calcium deposition in the skin, very very itchy

49
Q

What glucocorticoid is ineffective in cats?

A

PREDNISONE (surprise, they don’t have the necessary enzyme to break it down into prednisolone)

50
Q

Dosing Steroids in Cats

A

round UP - generally require more as they are more “resistant” than other species

51
Q

If cats get diabetes mellitus from steroid administration, is it reversible?

A

sometimes

52
Q

Iatrogenic Addison’s

A

d/t rapid withdrawal of steroids; signs include dullness/depression/fatigue, GI signs, and unthrifty appearance

53
Q

Local Glucocorticoids

A

topical, OTIC, or eye preparations; can still have systemic effects d/t lipophilia (easily absorbed)

54
Q

Soft Glucocorticoids

A

have a very high first pass effect and are rapidly absorbed by the liver, so they have very minimal systemic effects

55
Q

Examples of Soft Steroids

A

budesonide PO (chronic enteropathy), fluticasone (asthma)

605 Pharmacology (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions