Glucocorticoids/Corticosteriods

Question 1

the adrenal cortex produces

Answer 1

produces glucose-regulating steroids; these drugs very similar.

Question 2

Corticosteriods do what to glucose **

Answer 2

raise blood glucose

Question 3

Corticosteriods do what to sodium/water *****

Answer 3

causes retention of sodium and water

Question 4

Corticosteriods do what to fat **

Answer 4

fat deposits are mobilized

Question 5

Corticosteriods do what to the immune system *****

Answer 5

suppress immune response and inflammation (why we take them)

Question 6

Corticosteriods do what to neonates

Answer 6

mature their lungs at birth

Question 7

process of inflammation:

Answer 7

Release of chemical mediators (prostaglandins, histamine, leukotrienes):

Question 8

the immune response causes

Answer 8

vasodilation and increased capillary permeability

Question 9

the immune response initiates

Answer 9

characteristic symptoms of pain, swelling, redness, & warmth

Question 10

the immune response amplifys

Answer 10

action of lymphocytes & phagocytic cells (neutrophils & macrophages)

Question 11

Indications for the Glucocorticoids function**

Answer 11

Anti-inflammatory and immunosuppressant effects

Question 12

Therapeutic uses in nonendocrine disorders

Answer 12

asthma; Rheumatoid arthritis; Systemic lupus erythematosus; Inflammatory bowel disease; Miscellaneous inflammatory disorders

Question 13

Indications for the Glucocorticoids

Answer 13

Allergic conditions; Asthma; Dermatologic disorders; Neoplasms; Suppression of allograft rejection; Prevention of respiratory distress syndrome

Question 14

when use Glucocorticoids for Suppression of allograft rejection for what pts **

Answer 14

transplant pts

Question 15

adverse effects

Answer 15

Adrenal insufficiency; Osteoporosis; Infection; Glucose intolerance; Fluid and electrolyte disturbance; Cataracts and glaucoma; Peptic ulcer disease; Myopathy; Growth retardation; Psychologic disturbances

Question 16

adrenal insufficiency

Answer 16

pharmacologic doses of glucocorticoids can SUPPRESS production of body’s glucocorticoids

Question 17

Glucocorticoid withdrawal should be done

Answer 17

SLOWLY; example, taper the dosage over 7 days, or switch from multiple doses to single doses or taper the dosage to 50% of physiologic values over a month’s time (Consider NSAIDs during withdrawal to minimize symptoms)

Question 18

Monitor for signs of adrenal insufficiency:

Answer 18

↓BP, ↓glucose levels, myalgia, arthralgia, & fatigue

Question 19

Osteoporosis**

Answer 19

glucocorticoids suppress bone formation

Question 20

All patients should receive**

Answer 20

calcium and vitamin D supplements

Question 21

Na+ restriction + thiazide diuretic can

Answer 21

enhance intestinal absorption of calcium

Question 22

a biophosphonate (alendronate/ Fosamax) inhibits

Answer 22

bone resorption

Question 23

Infection:

Answer 23

by suppresing the immune response, glucocorticoids increase susceptibility to infection AND reactivating a latent infection

Question 24

signs and symptoms of infection may

Answer 24

not be evident, even though infection is present

Question 25

Patients should avoid

Answer 25

close contact with people who have a communicable disease

Question 26

Glucose intolerance:

Answer 26

glucocorticoids increase blood glucose levels

Question 27

Diabetics may need to

Answer 27

reduce caloric intake or increase dosage of hypoglycemic agents/insulin

Question 28

Patients on long term steroid use should have

Answer 28

periodic blood glucose levels checked

Question 29

Fluid and electrolyte disturbance:

Answer 29

Iatrogenic Cushing’s Syndrome

Question 30

Iatrogenic Cushing’s Syndrome symptoms

Answer 30

• hypertension
• fluid retention/ overload/ weight gain/edema
• Na+ retention (may need to restrict Na+ intake)
• K+ loss (watch for dysrhythmias/signs of hypokalemia; take K+ supplements/high K+ foods

Question 31

peptic ulcer disease

Answer 31

by ↓ prostaglandin production, gastric acid ↑

Question 32

Use in pregnancy and lactation:

Answer 32

glucocorticoids can cross placenta- prolonged use/high doses can cause fetal adrenal suppression; crosses to breast milk

Question 33

Drug interactions

Answer 33

Interactions related to potassium loss; Nonsteroidal anti-inflammatory drugs (NSAIDs & gastric ulcers); Insulin and oral hypoglycemics; Vaccines ( a live virus vaccine with glucocorticoid increases chance of developing virus-Avoid vaccines while on glucocorticoids

Question 34

Glucocorticoids/ Corticosteroids *****

Answer 34

(cortisone, prednisone, betamethasone, dexamethasone, hydrocortisone, methylprednisolone) (all end in sone)