Glucocorticoids

Question 1

Pathological effects:

Answer 1

• Diabetogenic ( insulin)
• Gluconeogenesis (GNG) increase (liver)
• Muscle atrophy, weakness
• osteoporosis (ca absorption low)
• delayed wound healing
• Skin thinning, alopecia
• Decreased growth (don’t give to animals under 1 year!)
• Polyuria/polydipsia

Question 2

Pharmacological effects:

Answer 2

Antinflammatory
Antiallergic
Immunosuppressive
Antishock, antiedema
Neuroprotective

antiendotoxin
antineoplastic (lymphoma)
substitusion therapy (Addison, CIRCI)

Question 3

Neuroprotective effects of glycocorticoids:

Answer 3

Glucocorticoids counteract lipidperoxidation and

enhance microcirculation

Question 4

Active substances of GCC and their effect:

Answer 4

• short:
  Cortisol least potent
• medium:
  Prednisolone
  Methylprednisolone
  Triamcinolone
• long:
  Betamethasone
  Dexamethasone

Beclomethason (local)
Fluticason (local) Most potent
Budesonide (oral)

Potency follows the list from cortisol to fluticasone

Question 5

Side effects of GCC:

Answer 5

1. Hypophysis adrenal (HPA) cortex axis inhibition
   approx. 1-2 weeks —> cortex atrophy
2. Gastric ulcers
3. Hepatopathy (ALKP significant increase)
4. Pancreatitis
5. Glaucoma, cataracta
6. Thinning of skin, delayed wound healing, alopecia
7. Polyuria/polydipsia
8. Polyphagia
9. Remobilizing fats
10. Muscle atrophy
11. Immunosuppression
12. Iatrogen cushings

Question 6

ADT (alternate day therapy):

Answer 6

prednisolone, methylprednisolone
Every other day
Mornings (dog), evenings (cat)

Question 7

When to use long acting injections (depot):

Answer 7

only if ADT not possible

Question 8

High dosage, once is used in case of:

Answer 8

IV: e.g. shock, spinal trauma (allergy)

Question 9

_recommended order for GCC treatment:

Answer 9

1. Local usage (atopic dermatitis, otitis externa,
2. Single injectable dose
3. Asthma, RAO  Inhalational usage
4. Intraarticular
5. ADT
6. Depot injections

Question 10

Consequence of stopping GCC treatment to quickly:

Answer 10

Addisons disease

Question 11

Indications for use of glucocorticoids:

Answer 11

• Severe allergic reactions e.g . anaphylaxis
• Orthopedic inflammations : osteoarthrosis , osteoarthritis when NSAIDs are not enough
• GI inflammations : IBD budesonide ), chronic hepatitis
• Respiratoryinflammation : allergic bronchitis, asthma ,
  RAO (beclomethasone , fluticasone)
• Endotoxinaemia
• Immunosuppression
• Lymphoma (in combination)