Iatrogenic complications of Steroids Flashcards
Why does cortisol levels affected by meals?
cortisol is a glucocorticoid: affected by glucose levels i.e. meals
aldosterone receptor have higher affinity for Cortisol or aldosterone?
Cortisol
How does the kidney protect it’s aldosterone receptors from cortisol always binding?
enzyme located near aldosterone receptor that converts cortisol to cortisone at kidney
what happens to cortisone converted at kidney?
In liver, it converts it back to cortisol
In primary adrenal hypofunction, you get cortisol deficiency and also?
Mineralcorticoid deficiency
Most common form of adrenocortical insufficiency is?
Autoimmune
How to dose cortisol?
Mimic physiological time-course with meals
Mineralcorticoid deficiency effects?
kyperkalaemia
hyponatraemia
dehydration
If infections, how take cortisol
take extra, twice as much is ok
if primary adrenal insufficiency patients, then must take cortisol and also?
fludrocortisone
too much glucocorticoids and immune suppression could lead to?
reactivation of latent TB
too much cortisol leads to what 5 major things?
- weight gain
- muscle, skin, bone wasting
- hyperglycaemia
- HTN
- inhibition of growth
What is transactivation in steroids?
activation of gene transcription via GREs
What is transrepression in steroids?
reduction of gene transcription via inhibition of AP-1 and NF-kB
major complication of glucocorticoid therapy?
adrenal suppression
