Stress Dose Steroids

Question 1

What does cortisol do for gluconeogenesis? What does it do to proteins, fats, and insulin sensitivity?

Answer 1

Stimulates gluconeogenesis
Increases protein catabolism
Increases lipolysis
Decreases insulin sensitivity of adipose tissue

Question 2

ACTH and CRH are controlled by negative feedback through which thing?

Answer 2

Cortisol

Question 3

Cortisol and histamine/serotonin from mast cells and platelets?

Answer 3

Cortisol has anti-inflammatory effects, and inhibits release of histamine and serotonin from mast cells and platelets

Question 4

What does cortisol do for calcium homeostasis?

Answer 4

it stimulates osteoclasts and inhibits osteoblasts 
Stimulates PTH (excretes hCO3- and phosphate)

Question 5

How does cortisol maintain vascular response to catecholamines?

Answer 5

By up regulating alpha adrenergic receptors on arterioles

Question 6

What does chronic glucocorticoid therapy do as far as HPA axis and other things?

Answer 6

Suppresses the HPA axis
Impairs wound healing
Increases risk of fractures, infections, GI hemorrhage and ulcers

Question 7

Criteria for when to give steroids:

Answer 7

5 mg or less per day-no stress dosing, no alternate day therapy
more than 5 mg within previous day-give it.
Moderate: 50 mg
Major: 100 mg