Unit 6 Discussion Questions (incomplete) Flashcards
When is the most appropriate time for administration of corticosteroids?
the early morning before 1000 AM
Where are the receptors for the “steroid” hormones?
found on the plasma membrane, in the cytosol and in the nucleus of target cells.
What is the mechanism of action of corticosteroids on carbohydrate metabolism?
Glucocorticoids decrease glucose uptake in peripheral cells, contributing to hyperglycemia. Insulin levels rise in response to increased glucose but glucocorticoids cause insulin resistance on hepatic cells stimulating gluconeogenesis and glycogenolysis further contributing to hyperglycemia.
What is the mechanism of action of corticosteroids on lipid metabolism?
Glucocorticoids increase lipolysis by triggering activation of lipases found in adipose tissue. Elevations in serum free fatty acids contribute to impaired glucose.
What is the mechanism of action of corticosteroids on the immune responses?
Bind to specific receptors in the cell causing inhibited production of cytokines and pro-inflammatory proteins such as chemotactic proteins. Result: immunosuppression and down regulation of inflammatory processes.
What are the mechanism of action of the corticosteroids on the “stress response”?
Corticosteroids are secreted in initial phase of stress response but second to the immediate release of catecholamines in reaction to stress. corticosteroids serve as resources to serve flight or fight response.
What are the mechanism of action of the corticosteroids on sleep?
Corticosteroid secretion is closely connected with the sleep-wake cycle modulated by melatonin secretion from the pineal gland in response to light-dark patterns.
What is considered short term usage of corticosteroids in comparison with long term usage?
short term is 2 weeks or less
A patient has been taking corticosteroid therapy for 4 weeks. What is important to educate to this patient?
To taper therapy down.
Tapering is necessary for corticosteroids taken longer than 2 weeks.
What happens if a patient does not taper their glucocorticoid administration schedule?
they sill have symptoms of adrenal insufficieny: dehydration, weight loss, low blood pressure, tiredness, changes in personality, hyponatremia and hypokalemia Comes from the suppression of the HPA.
Adverse effects of glucocorticoids on skin, muscle, bone, endocrine, CNS, and electrolytes :
skin: thinning and purpura
muscle: myopathy, muscle weakness
bone: induce osteoporosis
endocrine: increased blood glucose levels
CNS: psychosis
Electrolyte: hypokalemia
