Shared Flashcard Set

Details

Clinical use of Corticosteroids
Lecture 3
9
Pharmacology
Professional
09/21/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
What are the clinical uses of steroids?
Definition
Asthma/COPD
Immunosuppression
Autoimmune diseases
Inflammatory bowels
Dermatology
Term
What induces the hypothalamus in the HPA axis?
Definition
Surgery/trauma
Stress
Infection
Hypoglycemia
Sleep
Hemorrhage/Pain/Fear
Term
What is the HPA axis?
Definition
Hypothalamus releases CRH --> anterior pituitary releases ACTH --> Adrenal cortex releases cortisol
Term
What are normal cortisol levels?
Definition
8-15 mg/day w/ a half life of 30-90 minutes. Released on a circadian rhythm
Term
What are the short term side effects of steroids?
Definition
Insomnia
Psychosis
Hyperglycemia - concern for diabetes
Hypokalemia
leukocytosis
infection risk increases
Term
What is HPA axis suppression?
Definition
exogenous steroid use causes adrenal gland - stopped production of cortisol
May need steroids or IV steroids in case of shock.
Suspect if on steroids >3 weeks
Term
How is HPA suppression diagnosed?
Definition
ACTH stimulation test
Check morning cortisol level, if >15 ok. If not, test adrenal gland by giving ACTH analog - cosyntropin 250 mg IV/IM --> plasma cortisol should increase by 5-7
S/S of withdrawal - an addison's crisis.
Term
What are the rules for a steroid taper?
Definition
- If dose > physiological, decrease dose by half every 5-7 days
- Once physiological doses reached, decrease by 1 mg per week
- If in doubt, do an ACTH test
Term
What patient education should be given with steroids?
Definition
Possible weight gain
Increased appetite
Take in the morning with food to avoid insomnia and GI upset
Compliance - do not discontinue abruptly
Supporting users have an ad free experience!