Steroidal Anti-inflammatory Flashcards
Describe the regulation of glucocorticoid secretion by the hypothalamic‐pituitary‐adrenal gland axis.
- Diurnal Rhythm CRF-> ACTH-> GC secretion
- Negative Feedback on Hypothalamus and Ant. Pituitary
- Stress
What are the metabolic effects associated with corticosteroids?
Inc Blood glucose (gluc neogenesis, lipolysis, proteolysis)
Can lead to muscle wasting, central fat deposition (moon face and buffalo hump) and Latrogenic cushings.
What are the mineralocorticoid effects associated with corticosteroids?
Hypertension,
Hypokalemia,
Sodium fluid retention,
Metabolic alkalosis.
Where do corticosteroids inhibit inflammation?
Phospholipase A2 primarily
What are the upside and downsides of using corticosteroids?
Upside: suppress chronic inflammation and autoimmune reactions
Downside: Decrease healing and immune protection
Which corticosteroids must be activated in the body?
Prednisone and Cortisone
Which organs activate/inactivate corticosteroids?
Liver-Activate
Kidney-Inactivate
Placenta- Inactivate
Which corticosteroids can be applied topically?
All but Cortisone and Prednisone ( they need to be activated
Which corticosteroid is the most common? What Is the GC:MC ratio?
Prednisone
5:1
Glucocorticoid to mineralocorticoid action
Which corticosteroid is the most potent anti-infammatory?
Dexamethasone
Which corticosteroid has the greatest ACTH suppression?
Dexamethasone
Which corticosteroid is used in emergency replacement therapy?
Cortisol
Which corticosteroids are salt retainers?
Anything with corti or predni in the name.
IE cortisone prednisone, desoxycorticosterone
What are some administration strategies we can use to minimize negative side effects?
- Alternate Day administration
- Direct application
- Tapered withdrawal
- Use shorter-acting and low MC drugs for LARGE DOSES
