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D1 Spring > Pharmacology - Adrenal Corticosteroids (Exam 5) > Flashcards

Pharmacology - Adrenal Corticosteroids (Exam 5) Flashcards

1
Q

Steroidal anti-inflammatory drugs

A

Corticosteroids

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2
Q

Non-steroidal anti-inflammatory drugs

A

NSAIDs

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3
Q

What is “Compound E” that was used to treat Rheumatoid Arthritis in 1949?

A

Cortisone

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4
Q

What are the different names for adrenal corticosteroids?

A

Adrenocorticosteroids
Adrenocorticoids
Corticosteroids
Steroids

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5
Q

Agents secreted by the adrenal cortex

A

Adrenal corticosteroids

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6
Q

T/F Corticosteroids are the same as anabolic steroids illicitly used by athletes

A

FALSE, corticosteroids are NOT anabolic (building), they are catabolic (breaking down)

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7
Q

What are common corticosteroids?

A

Hydrocortisone
Prednisone
Dexamethasone

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8
Q

What are the main therapeutic actions of corticosteroids?

A

Anti-inflammatory
Immuno-suppressive

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9
Q

Very effective but come with nasty, multiple side effects

A

Corticosteroids

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10
Q

Steroids are _________ rather than curative

A

palliative

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11
Q

In what conditions and treatments would you use NSAIDs?

A

Acute conditions
Short term treatments

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12
Q

How do NSAIDs act on the body?

A

Fast and short

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13
Q

In what conditions and treatments would you use corticosteroids?

A

Chronic, severe conditions
Long term treatments

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14
Q

How do corticosteroids act on the body?

A

Slow and long

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15
Q

What are the adverse effects of NSAIDs?

A

GI disturbances (minor)

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16
Q

What are the adverse effects of glucocorticoids?

A

Infections (ex: tuberculosis)
Delayed wound healing

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17
Q

What is the HPA axis?

A

Hypothalamus
Pituitary gland
Adrenal cortex

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18
Q

What is the stress response via corticosteroids?

A
  1. Carbohydrate metabolism (provide glucose for brain)
  2. Water and electrolytes (conserve salt and water)
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19
Q

What are some stressors that trigger corticosteroids to be released and cause a stress response?

A

Starvation/fasting
Injury/trauma
Infection

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20
Q

What are the 2 classes of steroid hormones?

A
  1. Corticosteroids (glucocorticoids, mineralocorticoids)
  2. Sex steroid hormones (estrogen, progesterone, testosterone)
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21
Q

What do corticosteroids and sex hormones come from?

A

Cholesterol

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22
Q

How do steroid hormones work?
(what do they bind to, what do they increase/decrease?)

A

Bind to DNA
Increase/decrease gene expression

Can have cellular changes or organ/systemic changes

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23
Q

What are the 2 types of corticosteroids?

A
  1. Glucocorticoids
  2. Mineralocorticoids
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24
Q

What do glucocorticoids affect?

A

Immediate carbohydrate metabolism

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25
What is the major glucocorticoid?
Cortisol (hydrocortisone)
26
When is the maximal release of glucocorticoids?
4-8 AM
27
What does stress cause for glucocorticoids?
10 fold increase
28
Which corticosteroid is more common in therapies due to its anti-inflammatory effects?
Glucocorticoids
29
What do mineralocorticoids affect?
Water and electrolyte balance
30
What is an example of a mineralocorticoid?
Aldosterone
31
What do mineralocorticoids increase and cause?
Increase water/salt retention, blood volume, and BP Cause hypertension
32
Which corticosteroid is anti-inflammatory, anti-allergenic, catabolic, and has decreased resistance to infection?
Glucocorticoids
33
Which corticosteroid retains sodium and water, and can cause hypertension?
Mineralocorticoids
34
Which corticosteroids are used to treat corticosteroid deficiency and autoimmune diseases?
Glucocorticoids and Mineralocorticoids
35
Which corticosteroids are used to treat GI diseases, organ transplants, asthma, and non-infectious inflammatory diseases?
Glucocorticoids only
36
T/F glucocorticoids can be used in infections
FALSE, they are prone to infection
37
How do glucocorticoids affect metabolism and water/electrolyte balance?
Use alternate energy sources Make glucose Decrease protein synthesis
38
How are glucocorticoids anti-inflammatory and immunosuppressive?
Decrease cytokines Suppress immune cells
39
T/F glucocorticoids cause body image alterations
True
40
Your body is unable to produce additional corticosteroids in response to stress
Adrenal insufficiency
41
What does adrenal insufficiency lead to?
Adrenal crisis
42
What are the symptoms of adrenal crisis?
Weakness Syncope Cardiovascular collapse Death
43
What can cause adrenal insufficiency at the dental office? What can be done to avoid this?
Extreme stress (like dental phobia) Surgery Pts are given more steroids prior to surgery
44
What happens to your body when you take corticosteroids, leading to adrenal insufficiency?
1. Corticosteroids provide negative feedback to pituitary 2. ACTH is not released 3. Adrenal glands are not stimulated - atrophy
45
T/F Exogenous corticosteroids can be tapered off quickly
FALSE, they must be tapered off slowly due to adrenal insufficiency/adrenal crisis
46
What are the routes of administration for corticosteroids important for dentists?
Topical Oral Intra-articular injection (TMJ)
47
When can dentists use corticosteroids?
1. Oral lesions (non-infectious) 2. Aphthous stomatitis (canker sore) 3. TMJ disorders 4. Lessen post-op complications
48
Contraindications of corticosteroids
Herpetic (HSV) lesions
49
What corticosteroid is used to treat aphthous stomatitis (canker sore)?
Triamcinolone acetonide (kenalog in orabase)
50
Which type of corticosteroid has minimal or no systemic effects?
Topical
51
Which corticosteroid is a topical steroid?
Triamcinolone acetonide (kenalog in orabase)
52
17% of pts with rheumatoid arthritis also have what?
TMJ problems
53
Which corticosteroids can be injected into joints?
Cortisone Hydrocortisone
54
Cortisone and Hydrocortisone injection into joints contain a mix of what?
Phosphate ester (soluble, rapid) + acetate ester (insoluble, sustained)
55
What is the glucocorticoid action and mineralocorticoid action of hydrocortisone?
Glucocorticoid action = 1 Mineralocorticoid action = 1
56
What are some oral findings after corticosteroid therapy?
Increased risk of infection Decreased wound healing (ex: mucosal surfaces)
57
People that use oral steroid inhalers, such as asthma patients, have an increased risk of what?
Oral candidiasis
58
T/F adrenal insufficiency/adrenal crisis is common
FALSE
59
Hypofunction of the adrenal cortex (ON EXAM)
Addison Disease
60
How do you treat Addison Disease?
ADD steroids Hydrocortisone (glucocorticoid) + desoxycorticosterone (mineralocorticoid)
61
Hyperfunction of the adrenal cortex (ON EXAM)
Cushing syndrome
62
What is the stress hormone?
Cortisone (aka hydrocortisone)
63
How is cortisone released?
Stress -> hypothalamus -> pituitary -> adrenal cortex
64
Which corticosteroids are short-acting?
"-sone" (ex: hydrocortisone, prednisone)
65
Which corticosteroids are intermediate acting?
"-olone" (ex: triamcinolone, prednisolone)
66
Which corticosteroids are long-acting?
"-methasone" (ex: dexamethasone, betamethasone)
67
Which hormone is released from the pituitary? What does it act on?
Adrenocorticotropic hormone (ACTH); acts on adrenal cortex

D1 Spring (47 decks)

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