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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
Q

What is the major glucocorticoid?

A

Cortisol (hydrocortisone)

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26
Q

When is the maximal release of glucocorticoids?

A

4-8 AM

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27
Q

What does stress cause for glucocorticoids?

A

10 fold increase

28
Q

Which corticosteroid is more common in therapies due to its anti-inflammatory effects?

A

Glucocorticoids

29
Q

What do mineralocorticoids affect?

A

Water and electrolyte balance

30
Q

What is an example of a mineralocorticoid?

A

Aldosterone

31
Q

What do mineralocorticoids increase and cause?

A

Increase water/salt retention, blood volume, and BP

Cause hypertension

32
Q

Which corticosteroid is anti-inflammatory, anti-allergenic, catabolic, and has decreased resistance to infection?

A

Glucocorticoids

33
Q

Which corticosteroid retains sodium and water, and can cause hypertension?

A

Mineralocorticoids

34
Q

Which corticosteroids are used to treat corticosteroid deficiency and autoimmune diseases?

A

Glucocorticoids and Mineralocorticoids

35
Q

Which corticosteroids are used to treat GI diseases, organ transplants, asthma, and non-infectious inflammatory diseases?

A

Glucocorticoids only

36
Q

T/F glucocorticoids can be used in infections

A

FALSE, they are prone to infection

37
Q

How do glucocorticoids affect metabolism and water/electrolyte balance?

A

Use alternate energy sources
Make glucose
Decrease protein synthesis

38
Q

How are glucocorticoids anti-inflammatory and immunosuppressive?

A

Decrease cytokines
Suppress immune cells

39
Q

T/F glucocorticoids cause body image alterations

A

True

40
Q

Your body is unable to produce additional corticosteroids in response to stress

A

Adrenal insufficiency

41
Q

What does adrenal insufficiency lead to?

A

Adrenal crisis

42
Q

What are the symptoms of adrenal crisis?

A

Weakness
Syncope
Cardiovascular collapse
Death

43
Q

What can cause adrenal insufficiency at the dental office? What can be done to avoid this?

A

Extreme stress (like dental phobia)
Surgery

Pts are given more steroids prior to surgery

44
Q

What happens to your body when you take corticosteroids, leading to adrenal insufficiency?

A
  1. Corticosteroids provide negative feedback to pituitary
  2. ACTH is not released
  3. Adrenal glands are not stimulated - atrophy
45
Q

T/F Exogenous corticosteroids can be tapered off quickly

A

FALSE, they must be tapered off slowly due to adrenal insufficiency/adrenal crisis

46
Q

What are the routes of administration for corticosteroids important for dentists?

A

Topical
Oral
Intra-articular injection (TMJ)

47
Q

When can dentists use corticosteroids?

A
  1. Oral lesions (non-infectious)
  2. Aphthous stomatitis (canker sore)
  3. TMJ disorders
  4. Lessen post-op complications
48
Q

Contraindications of corticosteroids

A

Herpetic (HSV) lesions

49
Q

What corticosteroid is used to treat aphthous stomatitis (canker sore)?

A

Triamcinolone acetonide (kenalog in orabase)

50
Q

Which type of corticosteroid has minimal or no systemic effects?

A

Topical

51
Q

Which corticosteroid is a topical steroid?

A

Triamcinolone acetonide (kenalog in orabase)

52
Q

17% of pts with rheumatoid arthritis also have what?

A

TMJ problems

53
Q

Which corticosteroids can be injected into joints?

A

Cortisone
Hydrocortisone

54
Q

Cortisone and Hydrocortisone injection into joints contain a mix of what?

A

Phosphate ester (soluble, rapid) + acetate ester (insoluble, sustained)

55
Q

What is the glucocorticoid action and mineralocorticoid action of hydrocortisone?

A

Glucocorticoid action = 1
Mineralocorticoid action = 1

56
Q

What are some oral findings after corticosteroid therapy?

A

Increased risk of infection
Decreased wound healing (ex: mucosal surfaces)

57
Q

People that use oral steroid inhalers, such as asthma patients, have an increased risk of what?

A

Oral candidiasis

58
Q

T/F adrenal insufficiency/adrenal crisis is common

A

FALSE

59
Q

Hypofunction of the adrenal cortex (ON EXAM)

A

Addison Disease

60
Q

How do you treat Addison Disease?

A

ADD steroids

Hydrocortisone (glucocorticoid) + desoxycorticosterone (mineralocorticoid)

61
Q

Hyperfunction of the adrenal cortex (ON EXAM)

A

Cushing syndrome

62
Q

What is the stress hormone?

A

Cortisone (aka hydrocortisone)

63
Q

How is cortisone released?

A

Stress -> hypothalamus -> pituitary -> adrenal cortex

64
Q

Which corticosteroids are short-acting?

A

“-sone”

(ex: hydrocortisone, prednisone)

65
Q

Which corticosteroids are intermediate acting?

A

“-olone”

(ex: triamcinolone, prednisolone)

66
Q

Which corticosteroids are long-acting?

A

“-methasone”

(ex: dexamethasone, betamethasone)

67
Q

Which hormone is released from the pituitary? What does it act on?

A

Adrenocorticotropic hormone (ACTH); acts on adrenal cortex

D1 Spring (47 decks)

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