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HLSC 220 Pharmacotherapeutics for Health Professionals 💊 > Glucocorticoids - Ch. 63 & Ch. 76 > Flashcards

Glucocorticoids - Ch. 63 & Ch. 76 Flashcards

1
Q

Where are glucocorticoids secreted from?

A

Adrenal gland–> Adrenal cortex

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2
Q

What does the adrenal medulla secrete?

A

Epinephrine and norepinephrine

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3
Q

What stimulates glucocorticoid release?

A

Anterior pituitary ACTH

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4
Q

What do glucocorticoids do physiologically?

A

Promote glucose availability
Protein metabolism
Fat metabolism
Supports SNS activity on blood vessels

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5
Q

Oversecretion of adrenocortical hormones leads to what?

A

Cushing’s syndrome

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6
Q

Under secretion of adrenocortical hormones leads to what?

A

Addison’s disease

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7
Q

What are some glucocorticoids drugs?

A

Prednisone (prodrug)
prednisolone
cortisone
dexamethasone

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8
Q

What is prednisone?

A

Drug of choice of oral glucocorticoids for anti-inflammatory purposes and hormone replacement

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9
Q

How are glucocorticoids administered?

A

inhalation
Nasally
Topically
Systemic (IV, PO)

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10
Q

What are inhaled glucocorticoids used for?

A

Asthma,COPD

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11
Q

What are nasal glucocorticoids used for?

A

Rhinitis
Prevent the recurrence of polyps after surgical removal

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12
Q

What are topical glucocorticoids used for?

A

Inflammations of the eye, ear and skin

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13
Q

What are systemic (IV, PO) glucocorticoids used for?

A

Hormone replacement
Immunosupression

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14
Q

What is the mechanism of action of glucocorticoids?

A

Alter gene expression of many proteins
-Help control inflammatory and immune responses

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15
Q

What are glucocorticoids used for?

A

Adreneocortical deficiency (lifelong replacement therapy)
Anti-inflammatory/immune suppression
-Chronic resp. illnesses
-Organ transplant
-Derm. diseases
-GI diseases
Leukemia and lymphoma (kill malignant cells)
Spinal cord injury
Cerebral edema

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16
Q

When is glucocorticoid use contraindicated?

A

Serious infections
-systemic fungal infections

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17
Q

When are glucocorticoid to be used cautiously?

A

Gastritis, reflect disease, peptic ulcer disease
Diabetes mellitus (leads to hyperglycemia)
Hypertension, HF, renal impairment
Pregnancy

18
Q

What adverse effects are associated with glucocorticoid use?

A

Mimic Cushing’s syndrome
Significant effects on all body systems

19
Q

What Cushing syndrome symptoms can glucocorticoids mimic?

A

-moon face
-buffalo hump (fat deposits on neck)
-abdominal fat
-thin arms and legs
-stria (red markings)

20
Q

What Cardiovascular adverse effects are associated with glucocorticoids?

A

HF
Cardiac edema
hypertension

21
Q

What CNS adverse effects are associated with glucocorticoids?

A

convulsions
headache
vertigo
mood swings
nervousness
insomnia
steroid psychosis

22
Q

What endocrine adverse effects are associated with glucocorticoids?

A

Growth supression
Cushing’s
menstrual irregularities
carbohydrate intolerance
hyperglycemia

23
Q

Why do glucocorticoids cause hyperglycemias?

A

Increase plasma glucose levels

24
Q

What GI adverse effects are associated with glucocorticoids?

A

peptic ulcers with possible perforation
pancreatitis
abdominal distention

25
Q

What integumentary adverse effects are associated with glucocorticoids?

A

Fragile skin
Petechiae
Ecchymoses
Facial erythema
Poor wound healing
Hirsutism
Urticaria

26
Q

What musculoskeletal adverse effects are associated with glucocorticoids?

A

Muscle weakness
Loss of muscle mass
Osteoporosis

27
Q

What ocular adverse effects are associated with glucocorticoids?

A

Increased intraocular pressure
Glaucoma

28
Q

Usually replacement therapy via glucocorticoids does not cause what adverse effect?

A

Cushing’s syndrome

29
Q

During what use of glucorticoids are major adverse effects more common?

A

Inflammation suppression uses
Immune suppression uses

-depends on dosage

30
Q

During times of stress what may need to happen with glucocorticoid replacement therapy?

A

Increase dosage
stressors = infections, surgery, traumas

e.g, 3 by 3 rule for febrile illness

31
Q

What is the 3 by 3 rule for febrile illness?

A

take 3 time the usual dose of glucocorticoids for 3 days

32
Q

What do glucorticoids do during immunosuppressant therapy?

A

Drug inhibits physiological control of cortisol secretion
-reduces ACTH

Cortex atrophy
-allows adrenal cortex to recover

33
Q

Sudden discontinuation of glucocorticoids can cause what?

A

Adrenal crisis

34
Q

What is adrenal crisis?

A

Adrenal incapacity to synthesis glucocorticoids
-not enough cortisol

35
Q

Symptoms of adrenal crisis?

A

Abdominal pain
Low BP
Dehydration (syncope, dizziness)
Shock, fatal
Nausea, vomiting
Extreme fatigue
Confusion, convulsions

36
Q

How is Adrenal crisis avoided?

A

Drug doses are tapered before being discontinued

37
Q

What should patients taking adrenal medications be taught?

A

Take all adrenal meds at the same time every day, usually in the morning, with food

38
Q

What drugs should be taken with caution when the patient is on glucocorticoids?

A

NSAIDs
-stomach ulcers

39
Q

What should the patient be taught to do after used inhaled glucocorticoids?

A

Rinse mouth to prevent oral fungal infections

40
Q

Who should patients taking glucocorticoids avoid contact with?

A

People with infections

-report fever, weakness, lethargy, sore throat

HLSC 220 Pharmacotherapeutics for Health Professionals 💊 (31 decks)

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