Glucocorticoids Flashcards
What is the pharmacologic uses of glucocorticoids?
Rheumatoid arthritis, systemic, lupus, IBS, inflammatory disorders, allergies, asthma, dermatologic disorders, suppression of allograft, rejection, neoplasm, respiratory distress syndrome
What adrenal disease are glucocorticoids used for diagnosing?
Cushing syndrome
What are the three hormones that the adrenal cortex secretes?
Cortisol, aldosterone, and androgen
What system regulates the secretion of adrenal hormones
Hypothalamus pituitary adrenal axis
What can cause HPA axis suppression
Long-term corticosteroid therapy
After how long does suppression of the HPA system happen while on corticosteroids
About one month
How long does it take to recover from HPA suppression
Up to 12 months
Which class of glucocorticoids are absorbed more slowly
Acetates
Since glucocorticoids are highly protein bound, what can affect the distribution of the drugs?
Hyperproteinemia pregnancy or low serum protein in the elderly
How are glucocorticoids classified?
By their onset and duration of action
What glucocorticoids are low potency short acting and used for adrenal insufficiency or weak anti-inflammatory agents
Cortisol and hydrocortisone
What glucocorticoids have medium potency are intermediate acting and used for systemic treatment and cancer inflammation all allergies and autoimmune disorders?
Prednisone, prednisone, methylprednisolone, and triamcinolone
What glucocorticoids are high potency and long acting
Dexamethasone and bethametasone
In general, what should the rule of prescribing glucocorticoids be?
Prescribed the smallest effective dose for the least amount of time
For patients who have been on long-term therapy with a glucocorticoid and are now discontinuing, the drug gradual taping of the drug is needed to allow recovery because:
The hypothalamic pituitary adrenal system
How do glucocorticoids work?
They suppress the production of prostaglandins which suppresses inflammation and decreases the amount of inflammation caused by damage
Pharmacologic effects of exogenous glucocorticoids include what
Inhibition of prostaglandins
What do glucocorticoid stimulate to increase blood sugar?
Gluconeogenesis
Why do glucocorticoids place patients at risk for osteoporosis?
Long-term use of glucocorticoids release amino acids from proteins in a skeletal muscle, including the protein matrix of the bone, so long-term therapy will lead to osteoporosis
What are the metabolic effects of glucocorticoids?
Raise blood sugar insulin resistance, hirsutism, increase in insulin production
What are the catabolic effects of glucocorticoids?
Increase protein breakdown, increased bone and connective, tissue, fat and skin wasting these can lead to osteoporosis or growth inhibition in children
What syndrome is an adverse effect of high dose steroid therapy?
Cushing syndrome
How do glucocorticoids contribute to steady state regulation of hematopoiesis?
They increase the total leukocyte count due to accelerating their release from the bone marrow
What physiologic cardiovascular effects to glucocorticoids have
Increase in red blood cells and leukocytes which leads to neutrophilia
