lecture 8 steroids

Question 1

Dexamethasone inhibits the production of which one of the following?

a) leukotrienes
b) prostaglandins
c) platelet activating factor (PAF)
d) the entire arachidonate pathway

Answer 1

d) the entire arachidonate pathway, –dexamethasone is a steroid

Question 2

steroid hormones have _____ backbones

Answer 2

cholesterol

Question 3

name the 4 types of steroids

Answer 3

1) glucocorticoids 2) mineralocorticoids 3) sex hormones 4) vitamin D

Question 4

The ketone version of cortisol is ____ and the aldehyde version of cortisol is _____

Answer 4

cortisone, hydrocortisone

Question 5

what is the most common oral steroid?

Answer 5

prednisone

Question 6

Between prednisone and predniSOlone, which is the active ketone (meaning immediate action without the conversion step)?

Answer 6

predniSOlone is the active one

Question 7

What does HPA in the HPA axis stand for?

Answer 7

Hypothalamus, anterior Pituitary, and Adrenal gland.

Question 8

Which corticosteroid is the least potent?

Answer 8

cortisone

Question 9

(T or F) steroids activate the flight or fight response acting like stress on the HPA axis

Answer 9

True

Question 10

(Tor F) cortisol levels are lowest in the morning and peak in the evening

Answer 10

false, cortisol is highest in the morning (fight or flight) and decrease in the evening (rest and digest)

Question 11

(T or F) steroids are anti-inflammatories as well as immuno-suppresants

Answer 11

true

Question 12

select the correct statement:

a) steroids can cause alteration of mood (bouts of rage)
b) steroids act secondarily as an antibiotic
c) steroids decrease blood pressure
d) steroids decrease production of RBC’s as a means to reduce oxygen carrying capacity

Answer 12

a) steroids can cause alteration of mood (bouts of rage)

Question 13

Would a steroid increase or decrease fibroblast production?

Answer 13

decrease, fibroblasts are used to repair/heal tissues and steroids inhibit healing

Question 14

Aldosterone is a ________ used for fluid retention

a) glucocorticoid
b) mineralocorticoid
c) sex hormone
d) NSAID

Answer 14

b) mineralocorticoid

Question 15

Your patient has an eye infection that is red, inflamed, and very painful. During your slit lamp exam, you notice the corneal epithelium is also damaged. Is a topical steroid ok to use on this pt?

Answer 15

no, steroids inhibit healing. you would want to use an antibiotic and that should resolve the inflammation. You could, however, use a topical steroid once the cornea is healed if swelling still persists.

Question 16

Which of the following is NOT a systemic contraindication for use of steroids

a) osteoporosis
b) peptic ulcer
c) fungal infection
d) hypotension

Answer 16

d) hypotension…..steroids can cause hypertension, therefore steroids would be contraindicated in patients with hypertension

Question 17

there is a drug interaction with steroids and which 3 drugs (combination of steroids and these causes enhanced metabolism of steroids)

Answer 17

barbituates, phenylbutazone, and phenytoin

Question 18

(T or F) Steroids should not be taken with anticoagulants such as aspirin and coumadin due to increased anti-coagulant effects

Answer 18

false, steroids decrease anticoagulant effects

Question 19

hypo-secretion of steroids from the adrenal cortex describes what disease?

Answer 19

addisons

Question 20

what are xanthomas?

Answer 20

lipid deposits on the skin

Question 21

what does a person with cushings syndrome have all over their body?

Answer 21

xanthomas

Question 22

Cushing syndrome is an adverse of effect of which of the following?

1) steroids
2) vitamin D deficiency
3) NSAIDS
4) narcotics

Answer 22

1) steroids

Question 23

which is the most potent topical steroid for eyecare?

a) Durezol
b) prednisone
c) predniSOlone
d) FML

Answer 23

a) Durezol

Question 24

which is the only topical steroid ester in eyecare?

a) Pred Forte
b) Vexol
c) Lotemax
d) Alrex

Answer 24

c) Lotemax (also the only preservative free eye ointment)

Question 25

Which is the least potent of the topical steroids?

a) Pred Forte
b) Pred mild
c) Durezol
d) Lotemax

Answer 25

b) Pred mild

Question 26

Why is it important to know what topical steroid is an ester?

Answer 26

ester based topicals are rapidly metabolized, less side effects, and you wouldnt want to use them with deeper inflammation. Also esters are less like to increase IOP and have less risk for cataracts (Lotemax is the only ester based steroid topical)

Question 27

topical steroids are indicated for which type of herpes?

Answer 27

herpes zoster but contraindicated for simplex

Question 28

steroids in general have associated risks with increased IOP and cataracts. in regards to oral vs topical, which ones have increased risk with which condition.

Answer 28

oral–>cataracts

topical–>increased IOP