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Pharm Exam 1 > Glucocorticosteroids > Flashcards

Glucocorticosteroids Flashcards

1
Q

Glucocorticosteroids, mineralocorticoids, and sex hormones precursors are all what?

A

Adrenocortical hormones (steroid molecules produced + released by adrenal cortex)

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2
Q

Functions of this drug include carbohydrate/lipid/protein metabolism, cardiovascular fx, and immune fx/inflammation.

A

Glucocorticosteroids

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3
Q

Which glucocorticosteroid has the greatest effect?

A

Hydrocortisone (b/c its just the exogenous form of cortisol, exactly the same structure)

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4
Q

What are the short acting glucocorticosteroids?

A
  1. Hydrocortisone (cortisol)
  2. Cortisone
  3. Fludrocortisone (mineralocorticoid)
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5
Q

What are the intermediate acting glucocorticosteroids?

A
  1. Methylprednisolone
  2. Prednisone
  3. Triamcinolone
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6
Q

What are the long acting glucocorticosteroids?

A
  1. Betamethasone
  2. Dexamethasone
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7
Q

How do glucocorticoids work?

A

Anti-inflammatory/immunosuppressive but also cause leukocytosis (increase WBC count) 2/2 demargination

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8
Q

What causes these effects: carb/lipid/protein metabolism, stimulate gluconeogenesis, promotes glucose formation, anti-insulin effect, decrease glucose uptake by cells, increase lipolysis/protein lysis, decrease protein synthesis?

A

Glucocorticosteroids

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9
Q

What effects do glucocorticosteroids have on bone?

A
  • Decrease Ca absorption from intestine
  • Increase mobilization of Ca from bone
  • Increase risk of osteoporosis - recommend Ca (1000-1200 mg/day) + VD (800-2000 IU/day)
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10
Q

What effects do glucocorticosteroids have on peptic ulceration?

A
  • Increase gastric output
  • Decrease synthesis of mucopolysaccharides (glycosaminoglycans)
  • Increase risk w/ NSAID use, total doses > 1 gm Prednisone + > 30 day DOT
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11
Q

What CNS effects do glucocorticosteroids have?

A
  • Euphoria, insomnia, psychosis -> Depression
  • Magnify existing conditions
  • Steroid psychosis
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12
Q

What effects do glucocorticosteroids have on edema + HT?

A

Na + H2O retention (mineralocorticoids)

  • Moon face (Cushings)
  • Buffalo hump (due to fat redistribution)
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13
Q

What effects do glucocorticosteroids have on growth?

A

Suppression in children due to HPA inhibition

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14
Q

Cataract formation, glaucoma, increase in hair growth, weight gain, acne…are all what?

A

Adverse effects of glucocorticoids

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15
Q

What are monitoring parameters for use of glucocorticosteroids?

A
  • Complete blood counts
  • Electrolytes
  • Plasma glucose
  • Lipid panels
  • Bone scan
  • Monitor pts for Na retention, edema + HT
  • Monitor pt peptic ulcer disease, osteoporosis + hidden infx
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16
Q

What are inhaled steroids used for?

A

Asthma + COPD

  • must rinse mouth after using to prevent candida (thrush)
17
Q

What are intranasal steroids used for?

A

Allergic rhinitis, non-allergic rhinitis, nasal polyps

18
Q

What are opthalmic steroids used for?

A

Post-op inflammation, conjunctivitis, corneal injuries

19
Q

What are rectal steroids used for?

A

Hemorrhoids + ulcerative colitis

20
Q

What are shampoo steroids used for?

A

Seborrheic dermatitis (Fluocinolone)

21
Q

Betamethasone, Budesonide, Cortisone acetate, Dexamethasone, Hydrocortisone, Methylprednisolone, Prednisolone, Prednisone, and Triamcinolone are all what?

A

Glucocorticosteroids that can be given systemically (PO or paraenterally)

22
Q

What are the high potency topical steroids?

A

Amcinonide 0.1%

Betamethasone diprop, augmented 0.05% cream

Betamethasone valerate 0.1% oint

Desoximetasone 0.05% gel, 0.25% cream, oint

Fluocinodine 0.05%

Halcinonide 0.1%

Triamcinolone acetonide 0.5%

23
Q

What can high potency topical steroids induce?

A

Majocchi granuloma (deep tissue tinea infx)

24
Q

What are the very high potency topical lotions?

A

Betamethasone diprop augmented 0.05% oint

Clobetasol propionnate 0.05%

Diflorasone diacetate 0.05%

Halobetasol propionate 0.05%

25
Q

What is the max amount of time a very high potency topical steroid should be used?

A

3 wks

26
Q

How is potency of topical steroids determined?

A

Extent to which agent causes cutaneous vasoconstriction “blanching effect”

27
Q

What should be used for tx of skin diseases characterized by inflamm, hyperproliferation, and/or immunologic phenomenon, and also burns + pruritus (i.e. allergic contact dermatitis, eczema, psoriasis)?

A

Topical steroids

28
Q

What is important to consider before tx w/ steroids?

A

Get an accurate dx by skin scraping/potassium hydroxide tests (tells you steroid vs. antifungal; steroids can exacerbate a fungal infx)

29
Q

What is the most common SE of topical steroids?

A

Atropy of epidermis/dermis

30
Q

Acneiform eruption, folliculitis, rosacea, atrophy, skin fragility delayed wound healing, purpura, erythema, hypopigmentation, masking/aggravation of dermatophyte infx, secondary infx or aggravation of exisiting infx, and contact dermatitis are all what?

A

ADR for topical steroids

31
Q

Which preparation of topical steroids is used for treating dry/thick, hyper-keratotic lesions, provides good occlusion (which improves absorption), and should not be used on hairy/intertriginous areas (may cause maceration/folliculitis)?

A

Ointment

32
Q

Which preparation of topical steroids is useful for acute exudative inflamm (b/c drying effect), can be used on intertriginous areas (groin, gluteal cleft, axilla), has good lubrication, is cosmetically appealing, may contain preservatives (irritation, stinging + allergic rxn), and is less potent than ointments?

A

Creams

33
Q

Which preparation of topical steroids is the least greasy/occlusive, may contain alcohol (drying effect on oozing lesion), is useful for hairy areas, and is beneficial for exudative inflamm (poison ivy)?

A

Lotions -> contain alcohol

Gels -> poison ivy

34
Q

Which is the most expensive preparation out of the 3 topical steroids: foams, mousses, shampoos?

A

Foams

Pharm Exam 1 (4 decks)

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