glucocorticoids in practice

Question 1

clinical indications of glucocorticoid use?

Answer 1

hypercalcaemia, profound inflam disorders, cerebral and spinal oedema, shock, neoplasia, replacement tx, IM dz, allergic dz

Question 2

clinical indications of glucocorticoid use?

Answer 2

hypercalcaemia, profound inflam disorders, cerebral and spinal oedema, shock, neoplasia, replacement tx, IM dz, allergic dz

Question 3

considerations for corticoid use in allergic dz

Answer 3

cost, appropriate dose, add adjunctive to help, alternative drugs - apical, cyclosporine

Question 4

considerations for corticoid use in IM dz

Answer 4

usually PRED, use appropriate dose w shortest acting agent for effect, 2 phases - induction (high dose once daily for 10d, reduce and again for 10d) maintenance of remission (alternate day tx + NSAIDs for 10d and then at d20 same dose but e48h, tapered at 2-4wks)

Question 5

what dose of pred rests adrenal on off day

Question 6

difference between cats and dogs with steroids?

Answer 6

cats are considered more steroid resistant - need higher dose 4-5mg/kg in cats 2-3mg/kg in dogs

Question 7

do dogs need gastroprotectants on steroids?

Answer 7

none have shown effect, but supposed to be more relevant in certain disorders - azotaemia, spinal cord trauma, hypovolaemia or anaemia

Question 8

adverse effects of steroids

Answer 8

PU/PD - psychogenic
polyphagia - risk of weight gain
effects of underdosing!

Question 9

considerations for corticoid use in allergic dz

Answer 9

cost, appropriate dose, add adjunctive to help, alternative drugs - apical, cyclosporine

Question 10

considerations for corticoid use in IM dz

Answer 10

usually PRED, use appropriate dose w shortest acting agent for effect, 2 phases - induction (high dose once daily for 10d, reduce and again for 10d) maintenance of remission (alternate day tx + NSAIDs for 10d and then at d20 same dose but e48h, tapered at 2-4wks)

Question 11

what dose of pred rests adrenal on off day

Question 12

difference between cats and dogs with steroids?

Answer 12

cats are considered more steroid resistant - need higher dose 4-5mg/kg in cats 2-3mg/kg in dogs

Question 13

do dogs need gastroprotectants on steroids?

Answer 13

none have shown effect, but supposed to be more relevant in certain disorders - azotaemia, spinal cord trauma, hypovolaemia or anaemia

Question 14

adverse effects of steroids

Answer 14

PU/PD - psychogenic
polyphagia - risk of weight gain
effects of underdosing!