Glucocorticoids

Question 1

where are glucocorticoids produced

Answer 1

adrenal cortex

Question 2

what are the 3 main functions of glucocorticoids

Answer 2

1) increase blood glucose
2) inhibit inflammation
3) inhibit leukocyte function

Question 3

how do glucocorticoids elicit their function

Answer 3

by blocking phospholipase A2 (PA2) -> inhibits synthesis of arachidonic acid -> no substrate for COX or LOX enzymes -> no prostaglandins or leukotrienes

Question 4

T/F glucocorticoids inhibit inflammation and essentially all WBC functions

Answer 4

T

Question 5

do NSAIDs or glucocorticoids have a more profound effect

Answer 5

glucocorticoids

Question 6

how do glucocorticoids block phospholipase A2

Answer 6

by synthesizing proteins that block inhibit phospholipases

Question 7

T/F plasma membrane receptors for glucocorticoids may be responsible for some of their rapid effects

Answer 7

T

Question 8

how do glucocorticoids elevate blood glucose

Answer 8

1) stimulate hepatic gluconeogenesis
2) inhibit glucose uptake in liver and muscle
3) lipolysis in adipose tissue
4) mobilize amino acids from non-hepatic tissue

Question 9

how may of all expressed genes are regulated by glucocorticoids

Answer 9

10-20%

Question 10

what catabolic effects are seen in patients with cushings syndrome (hyperadrenocorticism)

Answer 10

1) decreased muscle mass
2) thinning of skin
3) osteoporosis

Question 11

how are glucocorticoids distributed

Answer 11

by albumin and transcortin

Question 12

can you give a cat oral prednisone or prednisolone

Answer 12

prednisolone; they have poor oral absorption of prednisone

Question 13

can you give a dog oral prednisone or prednisolone

Answer 13

prednisone; they will convert it to prednisolone

Question 14

can you give a horse oral prednisone or prednisolone

Answer 14

prednisolone; they have poor oral absorption of prednisone

Question 15

what are the methods of absorption of glucocorticoids

Answer 15

topical, oral, IM, SQ, intra-articular

Question 16

what are some possible ADRs associated with glucocorticoid administration

Answer 16

• osteoporosis
• thinning of skin
• edema
• hypertension
• centripetal fat distribution
• hair loss
• gastric ulceration
• infection
• impaired wound healing
• increased appetite
• PUPD

Question 17

adverse effects of glucocorticoid administration are usually only seen after how much use

Answer 17

2 weeks

Question 18

the risk of adverse effects of glucocorticoids is related to (2)

Answer 18

1) duration of therapy
2) dose

Question 19

what is the goal of glucocorticoid use

Answer 19

using the SMALLEST POSSIBLE DOSE for TOLERATION of the condition

Question 20

T/F you can stop glucocorticoids abruptly with no risk of an ADR

Answer 20

F; must wean GRADUALLY to prevent adrenal insufficiency

Question 21

what happens if you stop giving glucocorticoids abruptly

Answer 21

adrenal insufficiency -> hypoglycemia, hypotension, hyponatremia, hyperkalemia -> can be FATAL

Question 22

in what case would you give glucocorticoids to a patient with an infection

Answer 22

gram negative septicemia

Question 23

what are the main signs that develop when a patient gets secondary hypoadrenocorticism from abrupt cessation of therapy and why

Answer 23

1) hypotension <- hyponatremia; water loss
2) arrhythmias <- hyperkalemia

Due to the effects of drugs on mineralocorticoids