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Anesthesia Drug Test Quick Facts > steroids > Flashcards

steroids Flashcards

1
Q

trade name of dexamethasone

A

decadron

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2
Q

how is dexamethasone supplied

A

4mg/mL
or
10mg/mL

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3
Q

MOA of decadron

A

primarily as an anti-inflammatory or immunosuppressant agent in the treatment of a variety of diseases

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4
Q

disease dexamethasone treats

A 
allergic
dermatologic
gastrointestinal
endocrine
hematologic
inflammatory
neoplastic
nervous system
ophthalmic
renal
respiratory
rheumatic
autoimmune
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5
Q

conditions dexamethasone treats

A

cerebral edema
chronic swelling
diagnostic agent for cushiness
antiemetic

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6
Q

MOA of dexamethasone

A

Decerases inflammations by:

1) suppression of neutrophil migration
2) decreased production of inflammatory mediators
3) reversal of increased capillary permeability
4) suppresses normal immune response

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7
Q

MOA of dexamethasone’s antiemetic activity

A

unknown

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8
Q

anti-inflammatory dose of oral, IM, IV dexamethasone

A

0.75-9 mg/day

divided into doses every 6-12 hours

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9
Q

intra-articular, intralesional or soft tissue dose of dexamethazone

A

0.4-6 mg/day

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10
Q

extubation or airway edema dose of dexamethasone oral, IM, IV

A

0.5-2 mg/kg/day

dividd into doses every 6 hours 1st 24 hours prior to extubatoin and continuing for 4-6 doses afterwards

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11
Q

antiemetic prophylaxis dose of dexmethasone oral or IV

A

10-20 mg 15-30 minutes before treatment on each treatment day

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12
Q

mild emotogenic dose of dexemethasone ORal, IM, IV

A

4 mg every 4-6 hours

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13
Q

cerebral edema dose IV of dexamethasone

A 
10 mg STAT
4 mg IM/IV
give as sodium phosphate every 6 hours until max response then go oral, and tapper if needed 
reduce dose 2-4 days
done 5-7 days
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14
Q

treatments of shock dose of dexamethasone

A

4-10 mg as single dose
repeat if needed
Adisonian crisis

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15
Q

unresponsive shock treatments of shock dose of dexamethasone

A

1-6 mg/kg as a single IV dose or unto 40 mg initially repeat boluses 4-6 hours while shock persists

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16
Q

physiological replacement dose ORAL IM IV dexamethasone dose

A

0.03-0.15 mg/kg/day or 0.6-0.75 mg/m2/day in divided doses every 6-12 hours

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17
Q

dexamethasone onset of action

A

prompt - IV

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18
Q

dexamethasone half-life

oral vs IV

A

oral 4 hours

IV 1-5 hours

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19
Q

peak in serum dexamethasone

A

1-2 hours
IM 30-120 minuts
IV 5-10 minutes

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20
Q

excretion of dexamethasone

A

urine

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21
Q

adverse reactions of dexamethasone

A

NUMEROUS

CV, NEURO-mood, SKIN, DM, Abdominal, Joints, Eyes, wounds, infections

22
Q

contraindications with dexamethasone

A

sulfite allergy
systemic fungal infections
cerebral edema

23
Q

trade name of hydrocortisone

A

solu-cortef

24
Q

how is hydrocortisone supplied

A

25mg/mL

25
Q

what is hydrocortisone used for

A 
anti-inflammatory
immunosuppresion
for:
dermatologic
endocrine
GI
hematologic
allergic
inflammatory
neoplastic
neurologic
opthlamic
renal 
respiratory
autoimmune
26
Q

MOA of hydrocortisone

A

decreases inflammation by suppression of migration of PMN leukocytes
reversal of increased cap peremeability

27
Q

what 2 big conditions is hydrocortisone indicated in

A

septic shock- when BP is not responding to fluids and vasopressors
Thyroid storm

28
Q

stress dose for surgical pt already known to be adrenally-suppressed or on chronic systemic IV steroids
minor
mod
major

A

minor - 25 mg/day 1 day
moderate 50-75 mg/day 25 mg q 8-12 hours for 1-2 days
major- 100-10 mg/day 50 mg q 8-12 hours 2-3 days

29
Q

septic shock dose of hydrocortisone

A

IV 50 mg q 6 hours

200 mg/day cont infusion 24 hours

30
Q

dose of hydrocortisone thyroid storm

A

IV 300 mg LD

100 mg q 8 hours

31
Q

onset of hydrocortisone

A

rapid

32
Q

metabolism of hydrocortisone

A

hepatic

33
Q

half life of hydrocortisone

A

8-12 hours

34
Q

excretion of hydrocortisone

A

URINE
17-hydrosteriods
17-ketosteriods

35
Q

Adverse reactions with hydrocortisone

A 
MANY
imapired wound healing
adrenal suppression
CV
neuro
skin
cushing's
DM
hyperglycemia
osteoporosis
36
Q

contraindications with hydrocortisone

A

systemic fungal infections
serious infections- except septic shock or MB meningitis-viral,fungal, tubercular skin lesions
IM with ITTP
intrathecal

37
Q

trade name of methylprednisolone

A

solu-medrol

38
Q

how is methylprednisolone supplied?

A

125 mg
40 mg
25 mg
IV in benzyl alcohol- mix with powder

39
Q

use of methylpredinisolone

A 
anti-inflammatory
immunosuppressant
for:
dermatologic
endocrine
GI
hematologic
allergic
inflammatory
neoplastic
neurologic
opthlamic
renal 
respiratory
autoimmune
40
Q

what major condition is methylprednisolone used for?

A

prevention of graft-v-host disease following allogenic bone marrow transplant

41
Q

MOA of corticosteriods

A 
decreased inflammation by suppression of migration of PMN leukocytes and reversal of increased capillary permeability
tissue-specific 
regulate gene expression
bind specific intracellular receptors
translocateion into the nucleus
wide array of physiological effects:
carb metabolism, protien, and lipid metabolism
maintenance of fluid and electrolyte homeostasis
CV
IMMUNE
MSK
Edocrine
Nerulogic
42
Q

dose of methylpredinisolone oral

A

2-60 mg/day 1-4 days

43
Q

dose of methylpredinisolone IM succinate

A

10-80 mg/day

once a day

44
Q

dose of methylpredinisolone IM acetate

A

10-80 mg every 1-2 weeks

45
Q

dose of methylpredinisolone IV

A

10-40 mg over a period of several minutes repeated IV or IM depending on clinical response
4-6 hours 125 mg for 48 hours

46
Q

onset of methylpredinisolone Oral
IM
IV
intra-aricular

A

oral 1-2 hours
IM 4-8 days
IV -rapid
IA- 1 week

47
Q

duration of methylprednisolone

A

30-36 hours oral
IM 1-4 weeks
IA 1-5 weeks

48
Q

half life of methylpredinisolone

A

3-3.5 hours

reduced in obesity

49
Q

Adverse Reactions with methylprednisolone

A

MANY - same as other corticosteriods

50
Q

contraindications of methylprednisolone

A 
hypersensitivity to ingredients
systemic fungal infections
administration of live virus vaccines
methylprednisolone formulations containing benzyl alcohol preservatives in premature infants
ITTP
intrathecal administration

Anesthesia Drug Test Quick Facts (19 decks)

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