Steroids Flashcards
describes steroids in general
anti-inflammatory
does not directly remove pain but can have indirect effect d/t dec inflammation
what are the sex steroids
estrogen
progesterone
androgen - testosterone
function of sex steroids
sexual characteristics
reproductive function
what are the corticosteroids
mineralocorticoids
glucocorticoids
function of corticosteroids
mineralocorticoids: controls fluid and electrolyte balance
glucocorticoids: metabolism and immune function (anti-inflammatory)
discuss testosterone
more expressed in males
androgenic - sexual characteristics; facial hair
anabolic - promotes metabolic and physio; inc muscle mass and catabolic
ergogenic - improves performance; power, strength and endurance
effects of anabolic androgenic steroids
inc muscle mass - hypertrophy and hyperplasia
inc in strength - inc calcium from SR or more sensitive
anti-catabolic effects - prevents breakdown
endpoints enhanced by training - still needs training
usual athletes that benefit from anabolic androgenic steroids
weightlifters
boxers
explosive sports
contact sports athletes
explain the hypothalamo-pituitary axis
hypothalamus releases CRH - stims ant pituitary
ant pituitary releases ACTH - stims adrenal cortex
adrenal cortex release cortisol - main corticosteroid in the body
enough cortisol - neg fback that prevents hypo and pit to release shit
exp inc in blood glucose as effect of cortisol
inc blood glucose or liver glycogen
inc in liver
- protein synthesis
- glycogen synthesis and storage
- glucogenesis
other tissues
- dec uptake and uti of glucose
- inc lipolysis
- inc proteolysis
- in fat absorption in abdominal tissue
physiologic effects of cortisol
inc blood glucose
anti-inflammatory
immunosuppresion
exp anti-inflammatory as effect of cortisol
inhibits eicosanoids synthesis - prostaglandins, thromboxanes and leukotrienes
inhibits chemotaxins
stabs lysosomes
vasoconstriction
inhib both cyclooxygenase and lypoxygenase pathways
exp immunosuppresion as effect of cortisol
dec WBC, RBC and platelets
enhance sodium and water reabsorption - causes edema or CHF
behavioral and mood changes - chronic
topical route
insect bite, allergy
eyedrops
inhalational route
if usual inhaler not enough use steroids
fast acting and immediate for asthma
oral route
chronic asthma and allergies
intravenous route
for severe allergic reaction - anaphylaxis
fastest onset
injection route
inject on joints, muscle or lig - not immed effect; day-wks
chronic use can damage
epidural route
transforaminal steroids - chronic LBP
lumbar epidural
done by experts
adverse effects of steroids
cushing’s syndrome
adrenocortical suppresion
catabolism
other shit
cushing’s syndrome
centripetal obesity
moon face
buffalo hump
hyperglycemia, HTN
easy briusing, thin hair, acne
cardiac hypertrophy
adrenal hyperplasia
tumors
striae of skin
emotional lability
osteoporosis
muscle wasting and weakness
adrenocortical suppression
anorexia
nausea/vomit
weight loss
lethargy
HA
fever
msucle and joitn pain
OH
catabolism
muscle wasting
muscle weakness
osteporosis
vertebral compression fracture
other adverse effects of steroids
peptic ulcers
inc risk to infections
growth retardation
glaucoma and cataracts
psychosis
hallucinations
delusions
short acting steroids
half-life: 8-12 hrs
cortisol
cortisone
intermediate acting steroids
half-life: 12-36 hrs
prednisone
prednisolone
6-methylprednisolone
triamcinolone - MC ontiment
long acting sterioids
half-life: 36-72 hrs
paramethasone
betamethasone
dexamethasone
discuss amitriptyline
inc descending inhib signals in dorsanl horn
pain modulation
limbitrol
anti-cholinergic effects of antidepressants
drowsy
dry mouth
blurry vision
constipation
diff urinating
weight gain
may manifest depression
discuss anticonvulsants
membrane stab - will not allow transmission of pain
pregabalin
carbamazepine
na valproate
gabapentin
side effects of anticonvulsants
fatigue
stomach upset
dizzy
blurry vision
discuss significance of half life in steroids
long lasting even if drug is cleared
pwede mag ka adrenocortical supression
taper of dapat
