Term
| Effects of Glucocorticoids on Intermediary Metabolism |
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Definition
| enhances glucose production & insulin release; stimulates hepatic gluconeogenesis; decreases peripheral glucose utilization (insuline resistance in muscle cells); increases proteolysis & release of amino acids; enhances fatty acid mobilization & lipolysis with increased release of fatty acids & glycerol into circulation & hepatic cholesterol synthesis; Net result: maintain adequate glucose supply to brain |
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Term
| Effects of Glucocorticoids on Water & Electrolyte Balance |
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Definition
| effects exerted by aldosterone through control of renal excretion of cations; promotes reabsorption of sodium in renal distal tubules; enhances renal excretion of K+ & H+ ions |
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Term
| Effects of Glucocorticoids on Cardiovascular and Blood Cells |
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Definition
| important for normal structure & function; potentiate vasoconstrictor action & adrenergic stimuli on small vessels, helping with capillary integrity; cause vasoconstriction when applied to skin by suppressing mast cell degranulation; decrease capillary permeability by reducing amounts of histmine released by basophils & mast cells; maintain normal blood volume by sodium retention; increase plasma hemoglobin concentration; elevates total WBC count; decreases circulating eosinophils, basophils, monocytes, & lymphocytes |
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Term
| Effects of Glucocorticoids on Immune System |
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Definition
| inhibits production of prostaglandins & leukotriene; stabilizes lysosomal enzymes; reduces manifestation of inflammation; suppressive effect on release of cytokines & chemokines |
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Term
| Effects of Glucocorticoids on CNS |
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Definition
| can readily enter brain and can influence mood, sleep patterns, & EEG activity; role is poorly defined though |
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Term
| Effects of Glucocorticoids on Skeletal Muscle |
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Definition
| required to maintain skeletal muscular strength; large amounts stimulate proteolysis in myocytes, secreation of glutamine & alanine, pain, & muscle weakness |
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Term
| Effects of Glucocorticoids on Stress |
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Definition
| protective effect; first, cortisol secreation is immediately released with it's initiation; second, pts under severe form require exogenous hormone to prevent hypoglycemia & circulatory failure |
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Term
| Guidelines for Pharmacological Glucocorticoid Therapy |
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Definition
| 1) initiate use ONLY if there is published evidence; 2) use glucocorticoid ONLY after other therapies have failed; 3) identify a specific therapeutic objective; 4) use objective criteria of therapeutic response; 5) administer a dose of glucocorticoid for a sufficient period of time to achieve desired response; 6) DO NOT administer glucocorticoids for longer than required; 7) terminate use if therapeutic response is not achieved, if adverse effects arise, or if max benefit is achieved |
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Term
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Definition
| glucocorticoid used to treat vasogenic type edema that occurs with brain tumors; also used to treat respiratory distress syndrome |
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Term
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Definition
| used to treat bacterial meningitis; anti-inflammatory effects include a reduction of brain edema & lactate; also, high doses may control manifestations of systemic lupus erythematosus, lupus nephritis (+ azathioprine or cyclophosphamide) & polyarteritis nodosa (+ cyclophosphamide); increases platelet life span when used in adjunct with IgM Abs to treat idiopathic thrombocytopenic purpura (ITP) |
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Term
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Definition
| systemic administration relieves symtpoms in many allergic diseases; use inhalant form as first-line therapy for mild to moderate asthma; use as adjuncts for anaphylactic reactions |
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Term
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Definition
| initial treatment in juvenile idiopathic nephrotic syndrome |
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Term
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Definition
| used in respiratory distress syndrome in premature neonates |
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Term
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Definition
| regimens devised to alleviate undesirable effects of chronic high-dose daily glucocorticoids therapy; usually twice the daily dose is given on alternate days |
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Term
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Definition
| potent steroid with both glucocorticoid & mineralocorticoid activity; most widely used mineralocorticoid; used to treat adrenocortical insufficiency associated with mineralocorticoid deficiency |
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Term
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Definition
| inhibits CYP17, inhibiting conversion of cholesterol to pregnenolone, effectively blocking all steroid biosynthesis; most effective inhibitor in Cushing's disease; |
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Term
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Definition
| inhibits CYP11B1 which converts 11-deoxycortisol to cortisol; inhibits both cortisol & aldosterone; usually added to ketoconazole to treat Cushing's disease |
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Term
| Treatment of Hyperaldosteronism |
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Definition
| remove adrenal adenomas or carcinomas by surgery; use spironolactone [Aldactone] to normalize K concentrations before surgery & with a low-Na diet; post-op glucocorticoid & mineralocorticoid replacement therapy increases survival |
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Term
| Hydrocortisone [cortisol] |
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Definition
| a glucocorticoid synthesized from cholesterol; potent mineralocorticoid activity; Half-life: 80-118 min; Excretion: urine; Labeled Uses: manage adrenocortical insufficiency, relief of inflammation, adjunct for ulcerative colitis |
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Term
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Definition
| synthetic glucocorticoid developed in 1950's; hepatic metabolism to active prednisolone; slight but significant mineralocorticoid activity; Half-life: 60 min; Excretion via urine; Uses: agent of choice for ORAL administration; Labeled Uses: allergic states, autoimmune dx, dermatologic conditions, edematous states, endocrine disorders, GI diseases, hematological disorders, MS, neoplastic dx, opthalmic dx, respiratory dx, rheumatic disorders, tuberculous meningitis; Administration: ORAL only |
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Term
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Definition
| synthetic glucocorticoid; hepatic metabolism; Half-life: >200 min; Excretion: urine 40%, feces 60%; Labeled Uses: intralesional, nasal inhalation: allergic rhinitis, ophthalmic, ocular inflammatory, oral inhalation: bronchial asthma; oral topical: inflammatory lesions, ulcerative lesions; systemic: adrenocortical insufficiency, dermatological dx, endocrine disorders, GI dx, hematologic & neoplastic disorders, rheumatic disorders, SLE; AEROSOL, TOPICAL, IV |
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Term
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Definition
| synthetic glucocorticoid; hepatic metabolism; NO mineralocorticoid activity; Half-life >300 min; excretion via urine & feces; Labeled Uses: systemic: anti-inflammatory or immunosuppressant (management of cerebral edema), Opthalmic: conjunctivitis, Otic; Administer IV, oral, & topical |
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Term
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Definition
| synthetic mineralocorticoid; hepatic metabolism; mineralocorticoid activity; half-life: >35 min; Excretion: urine & feces; ADRs: CV (hypertension, edema), CNS (convulsions, HA, dizziness), Dermatologic (acne, rash, bruising), Endocrine & Metabolic (hypokalemic alkalosis, suppression of growth, hyperglycemia, HPA suppression), GI (peptic ulcer), muscle weakness, ocular (cataracts); Labeled Uses: adrenocortical insufficiency in Addison's disease, adrenogenital syndrome; Administer: ORAL |
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Term
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Definition
| synthetic c17-lactone drug, a renal competitive aldosterone antagonist; competes with aldosterone, increasing NaCl & water excretion while conserving K & H ions; hepatic metabolism; mineralocorticoid activity; half-life >10 min; excretion via urine & feces; Uses: management of edema with excessive aldosterone excretion; ORAL |
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Term
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Definition
| synthetic derivative of ACTH; stimulates adrenal cortex to secrete glucocorticoids, androgenic substances, & aldosterone; stimulates adrenal cortex maximally; peaks about 45-60 min after an injection; Uses: diagnostic tests to differentiate primary adrenal from secondary adrenal adrenocortical insufficiency; Administer IM or IV |
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