Unit 6 Endocrine pt. 1 ppt. slides

Question 0

Corticosteroids need to be used pharmacologically for at least ____ to begin to suppress the hypothalamic-pituitary-adrenal axis (HPA) physiologically.

Answer 0

2 weeks

This is important because antibiotics (CYP3A4 inhibitors) would need to be used for 2 weeks to begin to effect a rise in corticosteroids.

Question 1

CYP3A4 inhibitors like antimicrobials can inhibit the metabolism of steroids. The result is :

Answer 1

A greater risk for adrenal suppression

Question 2

Which 2 steroids are less effected by inhibition of CYP3A4 than other corticosteroids ?

Answer 2

prednisone (Deltasone)

prednisolone (Medrol)

Question 3

Which antibiotics inhibit CYP3A4 when used concurrently with corticosteroids ?

Answer 3

azole antifungals: itraconazole and ketoconazole

1 macrolide: erythromycin

Question 4

CYP3A inducers of corticosteroids cause the effectiveness of corticosteroids to be reduced because they are metabolized faster. What are some examples of inducers ?

Answer 4

Antiseizure meds
Antivirals
TB meds (rifabutine, rifampin, rifapentine)
St. John's wort
Fluroquinolones - watch tendon rupture !

Question 6

While on antibiotic therapy educate patient on back up :

Answer 6

contraceptives

Question 7

Mechanism of action: Glucocorticoids
Hydrocortisone
Prednisone, Prednisolone, Methylprednisolone
Dexamethasone, Betamethasone

Answer 7

carbohydrate and protein metabolism
lipid metabolism
immune response
anti-inflammatory response
stress response

Question 8

How long can corticosteroids be used without tapering

Answer 8

< 2 weeks

Question 9

Indications for contraceptives:

Answer 9

prevention of pregnancy
acne vulgaris
emergency contraception
heavy menstrual bleeding

Question 10

What does hormone replacement therapy treat?

Answer 10

menopausal symptoms
colorectal cancer
osteoporosis
prevention of endometrial hyperplasia/cancer