Systemic Steroids Flashcards

1
Q

Steroids are used for a variety of conditions, including inflammatory conditions, immune suppression, and __________

A

adrenal insufficiency

to replace endogenous steroids that the adrenal gland is not producing (cortisol and aldosterone)

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2
Q

fludrocortisone replaces what endogenous steroid?

A

aldosterone

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3
Q

Any steroid replaces what endogenous steroid?

A

cortisol

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4
Q

This steroid mimics aldosterone.

It has mineralocorticoid activity, which is used to maintain a balance of water and electrolytes.

A

fludrocortisone

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5
Q

Fludrocortisone is FDA-approved for what disease?

What is it also used for off-label?

A

Addison’s disease

orthostatic hypotension

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6
Q

Commonly used steroids, such as prednisone and hydrocortisone, have more ___ activity

A

glucocorticoid activity

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7
Q

Does glucocorticoid activity have more or less anti-inflammatory effects?

A

more!

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8
Q

What is it called when systemic steroids can cause the adrenal gland to stop producing cortisol due to feedback inhibition?

A

suppression of the hypothalamic-pituitary-adrenal axis (HPA)

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9
Q

Why do long-term steroids need to be tapered off when they’re discontinued?

A

to give the adrenal gland time to resume cortisol production

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10
Q

This condition develops when the adrenal gland produces TOO MUCH cortisol, or when exogenous steroids are taken in high doses and the amount of cortisol produced is higher than what would have been produced naturally

A

Cushing’s syndrome

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11
Q

This condition happens when the adrenal gland is not making enough cortisol

A

Addison’s disease

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12
Q

Why should steroids not be stopped suddenly?

A

can be fatal! it can cause Addisonian Crisis

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13
Q

List some long-term effects of Steroids/cushing’s syndrome

A

1) glaucoma / cataracts
2) Acne
3) psych changes, HTN, hypothyroidism
4) GI bleeds, esophagitis ulcers
5) diabetes
6) poor bone health
7) impaired wound healing, infection
8) growth retardation, muscle wasiting
9) buffalo hump
10) pink-purple stretch marks (striae)

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14
Q

What can happen to women taking long term steroids?

A

hair growth on face and body (hirsutism)

irregular or absent menstrual periods

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15
Q

What are ways to reduce systemic steroid risk?

A

1) alternate day dosing (QOD) – decreases Cushing-like side effects
2) joints – inject into the joint
3) for a condition in the gut, use a steroid with low systemic absorption (ie budesonide - Entocort EC)
4) asthma - use inhaled steroids
5) lowest dose possible

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16
Q

What are the short acting systemic steroids?

A

cortisone - 25mg

hydrocortisone - 20mg

17
Q

What are the intermediate-acting systemic steroids

A

prednisone - 5mg
prednisolone - 5mg
methylprednisolone - 4mg
triamcinolone- 4mg

18
Q

What are the long-acting and highest potency systemic steroids?

A

dexamethasone - 0.75mg

betamethasone - 0.6mg

19
Q

List the steroids least potent to most potent

A
cortisone - 25mg
hydrocortisone - 20mg
prednisone - 5mg
prednisolone - 5mg
methylprednisolone - 4mg
triamcinolone- 4mg
dexamethasone - 0.75mg
betamethasone - 0.6mg

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20
Q

Brand: DexPak 6, 10 or 13 days, Decadron

A

generic: dexamethasone

21
Q

Brand: Solu-Cortef

A

generic: hydrocortisone

22
Q

Brand: Medrol, Solu-Medrol

A

generic: methylprednisolone

23
Q

Brand: Deltasone

A

generic: prednisone

24
Q

Brand: Millipred, Orapred ODT

A

generic: prednisolone

25
Q

Brand: Kenalog

A

generic: triamcinolone

26
Q

What is the prodrug of cortisol?

A

cortisone

27
Q

what is the prodrug of prednisolone?

A

prednisone

28
Q

Which steroid is available in a therapy pack and as an injection?

A

methylprednisolone