Steroids Flashcards
Which GC or MC rx can we expect to cross categories?
Cortisol (GC) can play on MC receptors.
Synthetics will have what element for longer halflife?
F for longer halflife.
Anti-inflammatory GC therapies
Arthritis Asthma Autoimmune disease Dermatitis Leukemia Nausea Neurologic injury Ocular inflammation & scarring spinal nerve transplants
Other GC therapies
BS B/P Na retention Epinephrine synthesis Fetal lung development Prenatal: ACTH inhibition because of \cortisol=/ACTH
MC Uses & rx
Replacement therapy only
fludrocortisone (remember that minerals are in blood, low MC will = salt wasting = dehydration)
MC needs replacement because some types of Rx will cause MC deficiencies. What are they?
NSAIDS ACE ARB Heparin CA blockers
Steroids (must be synthesised to be used (it’s not stored))
RX that will inhibit which steroid?
Etomidate (MC&GC)
Ketoconazole (MC&GC)
Glucocorticoids (GC)
Effects of GC
\immune \wound healing \adrenal suppression steroid diabetes hypertension ulceration mental changes
Which steroids will not work if you have a bad liver?
cortisone
prednisone
P450 inducers will ___ steroid clearance and will require ____ dosing
Increase
increase
drugs that induce P450
barbiturates
phenytoin
rifampin
P450 inhibitors will ___ clearance, and ____ dosing
What rx?
decrease
decrease
Macrolides (erythromycin, clarithromycin)
Itraconazole
HIV Protease Inhibitors (*navir)
Need liver? Cortisol
No, Has L for liver. :)
Need liver? Cortisone
yes
Need liver? prednisone
yes
