Gluticosteriods Flashcards
How should you avoid adrenal insufficiency?
Taper long term use of corticosteroids slowly
What are the low potency short acting?
Cortisol / hydrocortisone
What are the medium potency, intermediate acting
Prednisone, prednisolone, methylated prednisone, triamcinolone
What are the high-potency, long-acting steriods?
Betamethasone / Dexamethasone
What are the indications of the low-potency, short-acting steroids?
Adrenal insufficiency, weak anti-inflammatory agents
What are the indications of the medium-potency, intermediate-acting steriods?
Most often used. Used for cancer, inflammation, allergy, autoimmune disorders,
What is the indicated use of bethametasone?
Systemic + local use for skin disorders
What is the indicated use of dexamethasone?
Cancer and inflammation
For patients who have been on long-term therapy with a glucocorticoid and are now discontinuing the drug, gradual tapering of the drug is needed to allow recovery of which of the following
The hypothalamic-pituitary-adrenal system
What are the metabolic effects of glucocorticoids?
Stimulate gluconeogenesis (raise blood sugar, insulin resistance, hirsutism, and increase insulin production
What are the catabolic effects of glucocorticoids?
Increase protein breakdown
Increase bone resorption (osteoporosis)
Connective tissue, fat, skin wasting
What is an adverse effect of high dose steroid therapy?
Cushing syndrome (facial puffiness and redistribution of fat to the dorosocervical spine areas)
What are the cardiovascular effects of glucocorticoids?
Increase the number of total leukocytes and RBCs due to accelerating their release from bone marrow.
What are the cardiovascular adverse effects of steriods?
Ischemic heart disease and HF
What risk is associated with taking more than 7.5 mg/day prednisone?
Atherosclerotic heart disease, HF, TIA, and stroke
What are glucocorticoids known to increase the risk of?
Venous thromboembolism
What are the renal effects of glucocorticoids?
Retention of sodium and water (hypernatremia, edema, and HTN, hypokalemia)
What are the psychiatric and cognitive symptoms glucocorticoids cause?
Mania, hypomania, psychosis, depression, delirium and sleep disruption
What GI disorder is glucocorticoids used for first line?
Crohns disease
What are the GI effects of glucocorticoids?
Increase risk of gastritis, ulcers, GI bleeds (avoid with NSAIDs)
What are the immune effects of glucocorticoids?
increased susceptibility to infections (not inhaled or topical forms)
How should you prescribe steriods?
Smallest effective dose for least amount of time
