Pharm- Adrenal Flashcards
Short acting glucocorticoids- Names
- Hydrocortisone
- Cortisone
- Prednisolone, prednisone, methylprednisone
Short acting glucocorticoids- MOA
- Anti-inflammatory through AA pathway
- Feedback inhibition on HPA axis
- Vasoconstritive
- Salt retaining
Short acting glucocorticoids- Indications
- Replacement for adrenocortical deficiency
Short acting glucocorticoids- Duration & peak
- Peak 1-2 hrs
- Duration 8-12 hrs
Short acting glucocorticoids- SE
- Osteoporosis, cushings, cataracts, thin skin
Short acting glucocorticoids- Pt Ed
Taper off medication
Long action glucocorticoids- Names
Betamethasone, dexamethasone
Long action glucocorticoids- MOA
- Lack sodium retention
- Mimic naturally ocurring glucocorticoids
Long action glucocorticoids- Indications
- Cushing syndrome
- Endocrine disorders
Long action glucocorticoids- Duration & Peak
- Peak- 1-2 hrs
- Duration; 2-3 days
Mineralcorticoids- Names
Fludrocortisone
Mineralcorticoids- MOA
- Inhibits adrenal cortical secretion & pituitary corticotropin excretion
Mineralcorticoids- Indications
- Addisons disease
- Andrenogential disorder
Mineralcorticoids- Peak & Duration
Peak: 1-2 hrs
- Duration 1-2 days
Mineralcorticoids- AE
Edema, brusing, impaired healing, petechiae, rash, CHF
Corticosteroid Tapers
- Goal to avoid withdrawal
- 7-14 days to suppress HPA axis
- 9-12 months to restore fxn
- slow taper, by 5 mg per day
Acute dosing
- Moderate to high dose
Chronic dosing
- Minimum dose for shortest duration
- Morning dose best
- Alternate days if possible
Adjustment to stress
- Raise dose to allow increased stress response
- Increased glucose availability
Adrenal insufficiency- adjustment when ill
- Double dose
- High dose for surgery, trauma, ICU
