Glucocorticoids Flashcards
where are glucocorticoids produced
adrenal cortex
what are the 3 main functions of glucocorticoids
1) increase blood glucose
2) inhibit inflammation
3) inhibit leukocyte function
how do glucocorticoids elicit their function
by blocking phospholipase A2 (PA2) -> inhibits synthesis of arachidonic acid -> no substrate for COX or LOX enzymes -> no prostaglandins or leukotrienes
T/F glucocorticoids inhibit inflammation and essentially all WBC functions
T
do NSAIDs or glucocorticoids have a more profound effect
glucocorticoids
how do glucocorticoids block phospholipase A2
by synthesizing proteins that block inhibit phospholipases
T/F plasma membrane receptors for glucocorticoids may be responsible for some of their rapid effects
T
how do glucocorticoids elevate blood glucose
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
how may of all expressed genes are regulated by glucocorticoids
10-20%
what catabolic effects are seen in patients with cushings syndrome (hyperadrenocorticism)
1) decreased muscle mass
2) thinning of skin
3) osteoporosis
how are glucocorticoids distributed
by albumin and transcortin
can you give a cat oral prednisone or prednisolone
prednisolone; they have poor oral absorption of prednisone
can you give a dog oral prednisone or prednisolone
prednisone; they will convert it to prednisolone
can you give a horse oral prednisone or prednisolone
prednisolone; they have poor oral absorption of prednisone
what are the methods of absorption of glucocorticoids
topical, oral, IM, SQ, intra-articular
what are some possible ADRs associated with glucocorticoid administration
- osteoporosis
- thinning of skin
- edema
- hypertension
- centripetal fat distribution
- hair loss
- gastric ulceration
- infection
- impaired wound healing
- increased appetite
- PUPD
adverse effects of glucocorticoid administration are usually only seen after how much use
2 weeks
the risk of adverse effects of glucocorticoids is related to (2)
1) duration of therapy
2) dose
what is the goal of glucocorticoid use
using the SMALLEST POSSIBLE DOSE for TOLERATION of the condition
T/F you can stop glucocorticoids abruptly with no risk of an ADR
F; must wean GRADUALLY to prevent adrenal insufficiency
what happens if you stop giving glucocorticoids abruptly
adrenal insufficiency -> hypoglycemia, hypotension, hyponatremia, hyperkalemia -> can be FATAL
in what case would you give glucocorticoids to a patient with an infection
gram negative septicemia
what are the main signs that develop when a patient gets secondary hypoadrenocorticism from abrupt cessation of therapy and why
1) hypotension <- hyponatremia; water loss
2) arrhythmias <- hyperkalemia
Due to the effects of drugs on mineralocorticoids
