Term
| prototype glucocorticosteroid agonist |
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Definition
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|
Term
| prototype mineralocorticosteroid agonist |
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Definition
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|
Term
| prototype glucocorticoid antagonist |
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Definition
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|
Term
| prototype mineralocorticoid antagonist |
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Definition
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Term
| prototype corticosteroid antagonist (synthesis inhibitor) |
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Definition
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Term
| duration of action for cortisol |
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Definition
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Term
| duration of action for cortisone |
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Definition
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Term
| duration of action for prednisone |
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Definition
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Term
| duration of action for prednisolone |
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Definition
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Term
| duration of action for methylprednisone |
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Definition
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Term
| duration of action for triamcinolone |
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Definition
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Term
| duration of action for betamethasone |
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Definition
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Term
| duration of action for dexamethasone |
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Definition
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Term
| What are the two mineralocorticoids? |
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Definition
corticosterone
fludrocortisone |
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Term
| corticosteroid indications |
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Definition
rheumatoid arthritis
bronchial asthma
renal disease
lupus erythematosus
ocular disorders
organ transplants |
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Term
| Corticosteroids controls _________; they do not stop __________ of a disease. |
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Definition
| symptoms; progression (cure) |
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Term
| What is needed to make all corticosteroids? |
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Definition
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Term
|
Definition
1. circadian regulation and stress cause release of CRH from hypothalamus
2. CRH acts on anterior pituitary to release ACTH
3. ACTH acts on adrenal cortex to release steroid hormone
4. both ACTH and steroid hormone act as negative feedback to turn off release of CRH from the hypothalamus |
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Term
| What overrides the negative feedback mechanism in the H-P-A axis? |
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Definition
| stress (more cortisol is kicked out of the adrenal cortex) |
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Term
| When are glucocorticoid levels highest and lowest during the day? |
|
Definition
highest in the early morning
lowest in the evening |
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Term
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Definition
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Term
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Definition
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Term
|
Definition
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Term
| What metabolic effects do glucocorticoids have? |
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Definition
| stimulate gluconeogenesis |
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Term
| What catabolic effects do glucocorticoids have? |
|
Definition
protein catabolism
wasting of lymph, connective tissue, fat, and skin |
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Term
| What immunosuppressive effects do glucocorticoids have? |
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Definition
| inhibit cell mediated actions (especially lymphocytes) |
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Term
| What anti-inflammatory effects to glucocorticoids have? |
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Definition
| inhibit T cell activation, eosinophils, and mast cells (histamine) |
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Term
| Glucocorticoids are fat/water soluble. |
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Definition
| fat soluble (cholesterol) |
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Term
| absorption of glucocorticoids |
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Definition
rapid and comlete
DO cross BBB (because lipid soluble) |
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|
Term
| primary site of glucocorticoid metabolism |
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Definition
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|
Term
| primary route of glucocorticoid excretion |
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Definition
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Term
| How long does a short acting corticosteroid last? |
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Definition
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|
Term
| duration of action for hydrocortisone |
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Definition
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|
Term
| duration of action for fludrocortisone |
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Definition
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|
Term
| special use for fludrocortisone |
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Definition
|
|
Term
| What type of corticosteroid is hydrocortisone? |
|
Definition
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|
Term
| What type of corticosteroid is fludrocortisone? |
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Definition
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|
Term
| prototype corticosteroid for anti-inflammatory activity |
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Definition
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|
Term
|
Definition
localized inflammatory condtions
(ex: ulcerative colitis, dermatitis) |
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Term
| relative anti-inflammatory potency of hydrocortisone |
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Definition
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|
Term
| hydrocortisone biological half life |
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Definition
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|
Term
| hydrocortisone contraindications |
|
Definition
systemic fungal infection
recent ileocolostomy
intestinal anastomoses
abscess |
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|
Term
| How long does an intermediate acting corticosteroid last? |
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Definition
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|
Term
| What type of corticosteroids are prednisone and triamcinolone? |
|
Definition
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|
Term
|
Definition
adjunct for arthritis (short-term only)
asthma
COPD
ulcerative colitis/Crohn's disease
rheumatic disorders
dermatologic disorders |
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|
Term
| relative anti-inflammatory potency of prednisone |
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Definition
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|
Term
| Prednisone is _________ on its own. It must be metabolized in the ________ to an active metabolite. |
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Definition
|
|
Term
| plasma half life of prednisone |
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Definition
|
|
Term
| biological half life of prednisone |
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Definition
|
|
Term
| administration of prednisone |
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Definition
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|
Term
|
Definition
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|
Term
|
Definition
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Term
|
Definition
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|
Term
|
Definition
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|
Term
|
Definition
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|
Term
| prednisone and prednisolone |
|
Definition
| oral glucocorticoids (quick relief of asthmatic symptoms) |
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|
Term
|
Definition
ophthalmic disorders
respiratory diseases |
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|
Term
| plasma half life of prednisolone |
|
Definition
|
|
Term
| biological half life of prednisolone |
|
Definition
|
|
Term
| administration of prednisolone |
|
Definition
oral and injectable
(systemic and local) |
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Term
|
Definition
| intermediate acting glucocorticoid |
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|
Term
|
Definition
RA intra-articular injection
ulcerative colitis
severe alcoholic hepatitis |
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|
Term
| plasma half life of methylprednisolone |
|
Definition
|
|
Term
| biological half life of methylprednisolone |
|
Definition
|
|
Term
| adverse effects of methylprednisolone |
|
Definition
| vertigo, headache, weight gain (fluid retention), sodium/water retention, impaired wound healing |
|
|
Term
|
Definition
| intermediate acting glucocorticoid |
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|
Term
|
Definition
ophthalmic disorders
respiratory diseases |
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|
Term
| plasma half life of trimacinolone |
|
Definition
|
|
Term
| biological half life of trimacinolone |
|
Definition
|
|
Term
| administration of trimacinolone |
|
Definition
oral and injectable
(systemic and local) |
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|
Term
| administration of methylprednisolone |
|
Definition
oral and injectable
(systemic and local) |
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|
Term
| side effects of inhaled glucocorticoids |
|
Definition
-oropharyngeal candidiasis (thrush)
-dysphonia (hoarseness)
-adrenal suppression
-bone loss
-retarded growth (in children) |
|
|
Term
| mechanisms of action for inhaled glucocorticoids |
|
Definition
-reduce bronchial hyperreactivity
-decreased sythesis and release of inflammatory mediators
-decrease infiltration and activity of inflammatory cells
-decrease edema of the airway mucosa and mucus production
-increase responsiveness to beta-2 agonists |
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|
Term
| How long do long acting corticosteroids last? |
|
Definition
|
|
Term
|
Definition
respiratory diseases
respiratory distress syndrome
local inflammatory conditions
life-threatening/disabling conditions |
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|
Term
| relative anti-inflammatory potency |
|
Definition
|
|
Term
| plasma half life for betamethasone |
|
Definition
|
|
Term
| biological half life for betamethasone |
|
Definition
|
|
Term
| administration of betamethasone |
|
Definition
oral, topical, and injectable
(systemic and local) |
|
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Term
|
Definition
lupus
RA
life-threatening/disabling conditions |
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|
Term
| relative anti-inflammatory potency |
|
Definition
|
|
Term
| plasma half life of dexamethasone |
|
Definition
|
|
Term
| biological half life of dexamethasone |
|
Definition
|
|
Term
| administration of dexamethasone |
|
Definition
oral, topical, and injectable
(systemic and local) |
|
|
Term
| What drug is uses diagnostically in Cushing's? |
|
Definition
|
|
Term
|
Definition
| pituitary releases too much ACTH which causes too much release of cortisol |
|
|
Term
|
Definition
either adrenal releases too much cortisol or there is an ectopic release of ACTH or CRH that causes the adrenal to release too much cortisol
pituitary is NOT involved! |
|
|
Term
| cardinal signs of Cushing's |
|
Definition
moon face
glaucoma/cataract formation
hirsutism/masculinization
cervicodorsal fat (buffalo hump)
extremity thinning/atrophy
abdominal striae (purplish)
protuberant abdomen
truncal obesity
swelling (fluid retention, edema)
brittle bones (osteoporosis) |
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|
Term
| With the dexamethasone suppression test, no suppression means... |
|
Definition
| ectopic or adrenal problem |
|
|
Term
| With the dexamethasone suppression test, suppression means... |
|
Definition
|
|
Term
| adverse effects of glucocorticoids |
|
Definition
-adrenocortical insufficiency (HPA suppression)
-adrenocortical excess (Cushing's)
-CNS effects (psychological/behavioral changes, aggravation of pre-existing disorders)
-impaired wound healing
-MSS effects (osteoporosis, muscle weakness and atrophy)
-CV effects (fluid retention, edema, HTN) |
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|
Term
| Glucocorticoid withdrawal... |
|
Definition
| should be performed SLOWLY |
|
|
Term
| symptoms of glucocorticoid withdrawal syndrome |
|
Definition
hypotension
hypoglycemia
myalgia
fatigue |
|
|
Term
| With steroid withdrawal, the longer the duration of therapy, the ______________ the withdrawal. |
|
Definition
|
|
Term
| HPA axis recover may take _______ or up to _______. |
|
Definition
|
|
Term
| drugs that enhance corticosteroid effects |
|
Definition
estrogens
OCPs
antifungals
antibiotics
*all of these inhibit CYP450 enzymes* |
|
|
Term
| drugs that reduce corticosteroid effects |
|
Definition
antacids
cholestyramine
*these decrease absorption*
phenytoin
*inhibits CYP450 enzymes* |
|
|
Term
| corticosteroid contraindications |
|
Definition
infections
hypertension
psychosis
peptic ulcer disease
diabetes mellitus
osteoporosis
glaucoma
pregnancy (prednisolone preferred) |
|
|
Term
| What exams should be done before, during, and after steroid therapy? |
|
Definition
body weight
x-ray of spine
blood glucose
eye exam
blood pressure |
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