Term
| What NTs cause the hypothalamus to secrete CRH? |
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Definition
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Term
| What hormones from the pituitary are stimulated by CRH from the hypothalamus? |
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Definition
| ACTH and AVP (arginine vasopressin) |
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Term
| What is the T1/2 of ACTH? |
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Definition
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Term
| In which zone of the adrenal cortex is cortisol released? |
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Definition
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Term
| From what zone of the adrenal cortex is aldosterone released? |
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Definition
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Term
| What are the mediating factors controlling aldosterone secretion? |
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Definition
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Term
| From which zone of the adrenal cortex is DHEA secreted? |
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Definition
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Term
| What are the key enzymes involved in cortisol secretion? |
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Definition
17-alpha hydroxylase
11-beta hydroxylase |
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Term
| How much cortisol is excreted in the urine |
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Definition
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Term
| What are the short-acting exogenous glucocorticoids? |
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Definition
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Term
| What are the intermediate-acting glucocorticoids? |
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Definition
| Prednisone, prednisolone, methylprednisolone, triamcinolone |
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Term
| What are the long-acting glucocorticoids? |
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Definition
| Dexamethasone, betamethasone |
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Term
| What is the main issue with prolonged corticosteroid therapy? |
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Definition
| Withdrawal leads to adrenal insufficiency (due to negative feedback loop of cortisol on hypothalamus & pituitary) |
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Term
| What is a risk of concomitant corticosteroid + NSAID use? |
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Definition
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Term
| What is the role of steroids in leukemia/lymphoma? |
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Definition
| High doses induce apoptosis, downregulate lymphocyte production |
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Term
| Aldosterone effects on cardiovascular system? |
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Definition
| HTN and interstitial cardiac fibrosis |
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Term
| What is a pseudoallergy and example of one? |
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Definition
| Non-IgE related secretion of histamine (e.g. opiates) |
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Term
| What is a type I drug reaction? |
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Definition
| IgE mediated: drug-IgE complex binds to mast cells & results in release of histamine |
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Term
| What is a type II immune reaction? |
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Definition
Cytotoxic
Specific IgG or IgM antibodies directed at drug-hapten coated cells
Can present w/ thrombocytopenias, hemolytic anemia, neutropenia |
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Term
| What is a type III immune rxn? |
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Definition
Immune complexes
Drug-antibody complex deposits in cell tissues, resulting in inflammation
Serum sickness, fever, arthralgia, glomerulonephritis |
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Term
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Definition
delayed-type, cell mediated
MHC presents drug antigen to T cells
maculopapular rash, contact dermatitis |
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Term
| How long after drug exposure to see type I rxn? |
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Definition
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Term
| How long after drug exposure to see type III rxn? |
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Definition
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Term
| How long after drug exposure to see type IV rxn? |
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Definition
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Term
| What is the difference between drug tolerance induction and graded challenge? |
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Definition
Induction = pt has allergy, we are gradually introducing temporary tolerance (will need to be repeated if future administration required)
Challenge = we're not sure if they are allergic or not. Start w/ higher dose than tolerance induction |
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Term
| Cross reactivity btwn PCN and cephalosporin allergies? |
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Definition
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Term
| Which 3rd gen ceph should be avoided in pts w/ an aztreonam allergy? |
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Definition
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Term
| What's the lowest potency topical steroid for drug rash? |
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Definition
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Term
| What's the next lowest potency steroid for drug rash? |
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Definition
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Term
| What is the indication for high-potency topical steroids for drug rash? |
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Definition
| Indication- thicker skinned areas (palms of hands, soles of feet) |
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Term
| What are the two high potency topical steroids used for drug rash? |
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Definition
High potency- desoximetasone
Highest potency- Clobetasol |
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