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PHM 603- Immunology > Glucocorticoids DI > Flashcards

Glucocorticoids DI Flashcards

1
Q

Bioavailability of glucocorticoids

A

Range from 60-100%

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2
Q

Distribution of glucocorticoids

A

Moderate protein binding

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3
Q

Cortisol and prednisolone bind to transcortin with what kind of affinity?

A

High affinity with non-linear PB

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4
Q

Methylprednisolone binds to albumin with what kind of affinity?

A

Low affinity with linear PB

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5
Q

Patients with low albumin have more…?

A

…Cushingnoid symptoms

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6
Q

Free drug is…

A

…active

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7
Q

Metabolism of glucocorticoids

A

Varies with each patient

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8
Q

Liver disease will reduce what?

A

Interconversion to active steroids

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9
Q

Are cortisone and prednisone active or inactive?

A

Inactive

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10
Q

Drugs that cause metabolic inhibition of glucocorticoids

A

OCs, conjugated estrogen, macrolide ABX, ketoconazole, isoniazid, naproxen, cyclosporine

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11
Q

Drugs that enhance hypokalemia

A

Diuretics, amphotericin B, increased digitalis toxicity

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12
Q

Drugs that affect the metabolic induction of glucocorticoids

A

Phenytoin, phenobarbital, rifampin, carbamazepine, ephedrine (with dexamethasone)

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13
Q

Drugs that have metabolic induction BY glucocorticoids

A

Tacrolimus, cyclosporine, mycophenolic acid

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14
Q

Drugs that decrease steroid absorption

A

Cholestyramine, antacids

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15
Q

5mg of prednisone is equal to how many mg of cortisone?

A

25mg

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16
Q

5mg of prednisone is equal to how many mg of hydrocortisone?

A

20mg

17
Q

5mg of prednisone is equal to how many mg of methylprednisolone?

A

4mg

18
Q

5mg of prednisone is equal to how many mg of dexamethasone?

A

0.75mg

19
Q

Glucocorticoid TDM factors for use

A

Patient selection- assess their risks
Use evidence-based data
Long-term vs. short-term use
Circadian rhythms (take single dose in the AM)
Monitor and minimize ADEs
Evaluate objective outcomes for disease responses
Adjustment of GLU dosing regimens

20
Q

Adrenal gland ADEs

A

Adrenal atrophy, Cushing’s syndrome

21
Q

CV tissue ADEs

A

Dyslipidemia, HTN, thrombosis, vasculitis

22
Q

CNS ADEs

A

Changes in behavior, cognition, memory, mood, cerebral atrophy

23
Q

GI tract ADEs

A

GI bleeding, pancreatitis, peptic ulcers

24
Q

Immune system ADEs

A

Broad immunosuppression, activation of latent viruses

25
Q

Integument ADEs

A

Atrophy, delayed wound healing, erythema, hypertrichosis, perioral dermatitis, petechiae, glucocorticoid-induced acne, striae rubrae distensae, telangiectasia

26
Q

Musculoskeletal system ADEs

A

Bone necrosis, muscle atrophy, osteoporosis, retardation of longitudinal bone growth

27
Q

Eyes ADEs

A

Cataracts, glaucoma

28
Q

Kidneys ADEs

A

Increased sodium retention and potassium excretion

PHM 603- Immunology (21 decks)

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