Immuno-modulators (Corticosteroids - Glucocorticoids)

Question 1

Examples of drug (Corticosteroids - Glucocorticoids)

Answer 1

• Oral Preparations (Prednisolone, Hydrocortisone, Dexamethasone)
• Topical Preparations (Hydrocortisone, Betamethasone, Clobetasone)
• Parenteral Preparations (Methyprednisolone, Hydrocortisone, Triamcinolone)

Question 2

Mechanism of action (Corticosteroids - Glucocorticoids)

Answer 2

• Bind to glucocorticoid receptors
• This causes up-regulation of a variety of anti-inflammatory mediators and down regulation of pro-inflammatory mediators.
• This provides immunosupression
• Glucocorticoids also have metabolic effects including increased gluconeogenesis. Some glucocorticoids also have mineralocorticoid activity (discussed below).

Question 3

Indications (Corticosteroids - Glucocorticoids)

Answer 3

• Replacement therapy in adrenal insufficiency
• Post-transplantion immunosupression
• Treatment of exacerbations of a variety of inflammatory conditions (including eczema, rheumatoid arthritis, inflammatory bowel disease and multiple sclerosis).
• Treatment of acute asthma

Question 4

Side effects (Corticosteroids - Glucocorticoids)

Answer 4

• Sleep disturbance
• Mood disturbance / psychosis
• Hyperglycemia
• Immunodeficiency
• Easy bruising
• Moon-faced
• Increased abdominal fat
• Glaucoma
• Striae
• Hypertension
• Gastric irritation

Question 5

Important pharmacokinetics/pharmacodynamics (Corticosteroids - Glucocorticoids)

Answer 5

• A variety of different preparations are available described above.
• Drugs have differing degress of glucocorticoid and mineralocorticoid activity (discussed below).

Question 6

Patient information (Corticosteroids - Glucocorticoids)

Answer 6

• Avoid alcohol and caffeine
• Take with food to avoid gastric irritation
• Don’t stop abruptly
• Always tell doctors they are on prenisolone
• Carry steroid card
• Take higher dose when ill