Steroids, ENT, Pulmonay and Dermatology drugs - Module 4 Flashcards
Inflammation
- Pain
- heat
- redness
- swelling
Corticosteroids
are a group steroidal hormones. The prototypical, naturally occurring (endogenous) corticosteroid is “cortisol”
Cortisol
is secreted by the adrenals to:
- Modulate glucose levels and body responses to “stress”
- Temper the immune function, and thereby decrease the inflammatory response.
Eicosanoids
are local hormones that are derived from lipid molecules on the cell membrane of virtually all body cells.
corticosteroids and Cox-inhibitors
Corticosteroids are better antiinflammatories than Cox - inhibitors (like aspirin) because they inhibit all aspects of AA.
Eicosanoids work upstream of AA
corticosteroids also inhibit “leukotrienes” produced from the lipoxygenase enzyme.
** some of the products from that pathway contribute to allergies and asthma, corticosteroids can help in those ailments.
Corticosteroids - Short Term
First use in 1950, to treat autoimmune and allergic disease. these drugs appeared to be free of side-effects
Corticosteroids - Long Term
Long term use corticosteroids have major side - effects. Over a long period of use, pt taking corticosteroids actually develop a characteristic bydy habitus (body shape), and the person is said to be “cushinoid”
Ex. use long term to treat arthritis and lupus patients
Corticosteroids - Long Term
Cushinoid
moon faces, buffalo hump, thin skin with bruising, truncal obesity, muscle loss from thinning of extremities, hypertension, poor wound healing, edema…etc.
Corticosteroids drug- Local administration
Nasacort (triamcinolonge) and Flonase (fluticasone), inhaled corticosteroid keeping the blood levels low and less systemic side effects
Corticosteroids - systemic use
variety of creams, ointments, eye drops, ear drops, oral and systemic forms of corticosteroids.
Corticosteroids popular drugs - systemic use
Prednissone
triamcinolonge(Kenalog) - I.M
methylprednisolone( Solu-Medrol)- IV
methylprednisolone( Solu-Medrol)- IV
Can be used to treat an emergency anaphylactic reation
Sex Steroids “compare” to corticosteroids
different therapeutic effects and side effects compare to corticosteroids.
Sex Steroids
include a group of male and female sex hormones, responsible for the development of secondary “Sexual characteristics” in men and women and for libido.
Sex Steroids are
Estrogen and testosterone
Male androgen hormones
are testosterone and dihydrotestosterone (DHT)
Female estrogens
is estradiol (E2)
Anabolic steroids (Anabolic-androgen steroids AAS)
“Roids” or “arnolds” mimic the effects of testosterone and DHT - Building more muscle tissue
Anabolic-androgen steroids - AAS
Side effects of longer term use
Aggressive, behavior, coupled with decreased sperm counts and shrunken testes.
women - cause baldness and hirsutism
Dianabol (methandrostenolone)
first anabolic steroid in the US - Sch III
Human Growth Hormone
non-steroid, protein-based hormone r-hGH (recombinant human growth hormone)
Anabolic steroids drugs and HGH drugs
are scheduled III because of high rates of abuse
Abusing hGH
popular for athletes use due to the benefits:
* stimulation of muscle growth
* Loss of fat
* increased glucose output from the liver
Long term use will lead to acromegaly (large face)
Decongestants
The epinephrine-like drugs not only act on Beta RC, but also act as Alpha-agonist vasoconstrictors to reduce upper airway congestion.
Combo drugs (Decongestants + antihistamines)
- Phenylephrine (Neo-synephrine)
- Oxymetazoline (Afrin Nasal Spray)
cold remedies
Sudafed
Decongestants OTC
doesn’t contain pseudoephedrine, now contain “Phynyleprine”
Oxymetazoline (Afrin)
nasal spray for decongestants OTC
Antihistamines
drugs for allergy
these drugs block H1 RC on cells found in the nose and throat.
- when the H1 rc are blocked, histamine, which is released from mast cells, cannot bin and cause allergic effects.
Seldane and Hismanal
are antihistamines, were taking off the market in 1997 - cause fatal dysrhythmias
Claritine (loratadine)
antihistamines 2nd generation use today
OTC Antihistamines
- Claritin (loratadine)
- Fexofenadine (Allegra)
- Cetirizine (Zyrtec)
Antihistamines - 3rd generation
Allegra (fexofenadine) approved 1996
Zyrtec (cetirizine)
Antihistamines - first generation
- benadryl (diphenhydramine)
- Phenergan (promethazine)
tended to cause drowsiness, this side effect is used in many OTC sleep medicine - Dimetane (brompheniramine
*Chlor-Trimeton (chlorpheniramine)
Leukotriene Rc bloockers
are inflammatory mediators (eicosanoids) produced in AA pathway. they are involved in asthma and allergies
Leukotriene Rc blockers drugs
have been approved ONLY for the treatment of asthma and servere hay fever not responding to antihistamine therapy
Singulair (montelukast)
Leukotrience rc blockers drug belong to “ -Leukast” family
mast cell stabilizers
are used for allergies and asthma
* coat mast cells and prevent the release of their histamine granules (this causes the symptoms of an allergic reaction)
cromolyn (NasalCrom)
first mast cell stabilizers type drug and still in widespread use. Allergy prevention
Flonase (fluticasone) and Nasacort AQ (Triamcinolone)
treating airway inflammation (allergic rhinitis)
1st corticosteroid nasal spraythat can be purchased w/o a prescription hit the shelve in Spring 2014.
Antibioltics for ENT use
these drugs are used for bacterial (NOT VIRAL) infections in middle ear, nose and throat
- Pen VK,
- Ammoxicillin - Penicillin family
- Biaxin (clarithromycin) - Macrolide family
- ciprofloxacin (Cipro) - fluoroquinolone family
Antibioltics for ENT use - topical creams/ointments
ex. impetigo infections around the nose and mouth
* Bactroban (mupirocin)
* Neosporin ointment is called “triple antibiotic ointment”
(neomycin + polymyxin B + bacitracin)
Floxin Otic (ofloxacin)
is a otic solution of a fluoroquninolone antibiotic - otitis externa or swimmers ear.
Antivirals for ENT
the common cold is a acute, viral, upper respiratory infection - cased by viruses (usually rhino viruses)
Symptomatic therapy
means therapy that is directed a the symptoms of an illness, and not at the underlying cause of the disease.
3 viral infections of the upper respiratory tract
influenza - can be treated with “Relenza, Tamiflu or IIV4”
RSV in infants - don’t require drug therapy
herpectic cold sores - can be treated with “acyclovir”
3 antifungal drugs for ENT use
Miconazole
clotrimazole
nystatin
for oral thrush infections and can also be part of treating some sinus infections.
