Steroids Flashcards
Which steroids has the same level of effect as glucocorticoid and mineralocorticoid? and what are their duration of action?
Cortisol and hydrocortisol
short
Which steroids is a potent glucocorticoid w/o aldosterone effect? and what is its duration of action?
Dexamethasone
Long acting
What is glucocorticoid’s effect on leukocyte?
Inhibit leukocyte migration
What does chronic use of glucocorticoid cause?
Cushing’s syndrome/osteoporosis
What is chronic glucocorticoid’s effect in stomach?
Inhibit PGs—>increase acid and pepsin release
Which 2 steroids have side effect such as HTN and edema?
Mineralocorticoid—>cortisol/hydrocortisol
Sudden stop of steroid tx can cause?
Adrenal insufficiency (Addison’s disease)
How to minimize steroid toxicity?
Alternative day therapy/local application/tapering down
What are responsible for early asthmatic response?
Histamine and leukotriene
What drug can be used to test for asthma?
Look for hyper reactivity with methacholine (M agonist)
What do you see with late asthmatic response?
eosinophil and lymphocytes in the airway
How to approach asthma tx?
Bronchodilator and anti inflammatory
Adenosine cause bronchoconstriction or dilation?
Bronchoconctriction
What are the SABA and what are they used for?
Shorting acting beta 2 agonist—>DOC for acute asthma attack
Also prophylaxis for exercise induced asthma
Albuterol/metaproterenol/terbutaline
What are the LABA and what are they used for?
Long acting beta 2 agonist—>salmeterol/formoterol
Prophylaxis for nocturnal asthma
How is SABA and LABA administered and what happens with overuse?
Aerosol form
Anxiety/muscle tremor (beta2 effect on muscle)/cardiotoxicity
Ipratropium and tiotropium is most commonly used for asthma or COPD?
COPD
What is the mechanism of theophylline?
Inhibit phosphodiesterase type 3—>prevent degradation of cAMP—>bronchodilate
Block adenosine—>bronchodilate
Why is theophylline dangerous to use? and what is its toxicity?
Low TI—>interact with P450 inhibitors
High dose causes increase HR and arrhythmia
What drugs prevent mast cell degranulation thus have anti inflammatory effect? How are they used?
Cromoglycate and nedocromil
Alternative to glucocorticoid for asthma prophylaxis
What is MOA of omalizumab and what is it used for?
Anti-IgE—>prevent mast cell degranulation
Used subcutaneously for severe allergy induced asthma
What are the anti inflammatory drugs for asthma? how are they administered and what should you worry about?
budesonide/flunisolide/fluticasone
Inhalation—>risk for oral thrush
Which steroid is used intranasaly for allergy?
Fluticasone
How are “lukast” drugs given? and how are they used?
Orally
Prophylaxis
