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Pharm Test 4 > L 29 Glucocorticoids > Flashcards

L 29 Glucocorticoids Flashcards

1
Q

Short acting Glucocorticoids?

A

Cortisone

Hydrocortisone

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2
Q

Intermediate acting Glucocorticoids?

A

Prednisone
Prednisolone

Trimcinolone

Methylprednisolone

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3
Q

Long acting Glucocorticoids?

A

Betamethasone

Dexamethasone

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4
Q

What is the endogenous steroidal anti inflammatory? What is the source?

A

Cortisol

Adrenal Gland – Fasciculata

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5
Q

What are Glucocorticoids synthesized from?

A

Cholesterol

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6
Q

What is the HPA Axis?

A

Hypothalamus CRH

Ant. Pit ACTH

Adrenal Cortex

-> Cortisol

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7
Q

What is the difference between Cortisol & Dexamethasone?

A

Dexamethasone can inhibit HPA

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8
Q

What do Glucocorticoids negatively regulate?

A

HPA axis

CRH, ACTH secretion

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9
Q

Glucocorticoid MOA?

A

Ligand binds to cytosolic receptor

ligand/ receptor complex translocates to nucleus & binds to DNA

transcription of mRNA

Ptns are translated that induce effects of Gluco.

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10
Q

What are Glucocorticoid effects?

A

normal metabolism

Inc. stress resistance

alter blood cells

anti- infl

effects on other endocrine

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11
Q

Glucocorticoids can cause a modest rise in?

A

BP

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12
Q

How do Glucocorticoids alter circulating blood cells?

A

DEC.

eosinophils
basophils
monocytes

redistribute them to lymphoid tissue

INC.

hemoglobin
erythocytes
platelets

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13
Q

What are Glucocorticoids anti-inflammatory actions?

A

(-) phospholipase A2 by activating Lipocortin

Dec. activity of peripheral lymphocytes & macrophages

Interfere in mast cell degranulation = dec histamine & cap perm

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14
Q

What does Glucocorticoid do to other endocrine hormones?

A

Dec. TSH

Inc. GH

Neg feedback (-) further glucocorticoid synthesis

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15
Q

What are synthetic corticosteroids primarily bound to?

A

albumin

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16
Q

Glucocorticoid therapy should be monitored in pt w/?

A

hepatic dysfunction

17
Q

Why is the plasma 1/2 life shorter than the biological 1/2 life?

A

effects persist due to the ligand receptor complex sticking around vs plasma membrane receptor desensitization

18
Q

How is the potency defined?

A

ability to raise blood glucose

19
Q

What is the primary mineralocorticoid?

A

Aldosterone

20
Q

What do mineralocorticoids promote?

A

Na retention in kidney

affect BP

21
Q

What are mineralocorticoids effects based on?

A

Na retention

22
Q

What happens with large doses over an extended periods of time?

A

HPA axis suppression

23
Q

What should the dose regime be?

A

alternate day therapy

24
Q

What inflammatory diseases do Glucocorticoids Tx?

A

eczema, dermatitis

arthritis, bursitis, tenosynovitis

ulcerative colitis, Crohn’s

asthma, COPD

25
Q

How do Glucocorticoids inhibit the immune system?

A

autoimmune diseases

organ transplant

during surgery

allergic conditions

lupus

26
Q

What are Glucocorticoids other uses?

A

cerebral edema

premature delivery = dec res. & neonatal mortality

eye injury = (-) fibrosis

replacement therapy = Addison’s

27
Q

What are Adverse Effects?

A

Osteoporosis
Cataracts

Hyperglycemia
Infection Resist. Dec

Fluid & Electrolyte imbalance
PUD

Body Fat Redistribution
Muscle Mass Loss

Adrenal Suppression

28
Q

Why is Osteoporosis caused?

A

suppression of intestinal Ca2+ absorption

29
Q

What is the cause of Addison’s disease?

A

insufficient Glucocorticoid production

30
Q

Addisons symptoms?

A

chronic fatigue
muscle weak
wt. loss
appetite loss

31
Q

Addisons Tx?

A

Replacement therapy w/ Glucocorticoids

32
Q

Cushing’s syndrome cause?

A

excess glucocorticoids

33
Q

Cushing’s disease?

A

Pituitary over secretion of ACTH

34
Q

What does long term Glucocorticoid tx mimic?

A

Cushing’s syndrome

35
Q

Cushing’s syndrome symptoms?

A

wt. gain in trunk, face, & growth of fat pads in collarbone

central obesity, buffalo humor, moon face

easy bruising, skin atrophy

acne

hirusitism

36
Q

How to determine primary cushing’s syndrome from secondary cushing’s disease?

A

ACTH level test

Primary Cushing’s syndrome
= CRF overproduction

Secondary Cushing’s Disease
= ACTH over production

Pharm Test 4 (8 decks)

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