Term
| 8 corticosteroid effects = |
|
Definition
1. antinflam
2. immunosupressant
3. inhibit PLA2 and COX2
4. decr C' in plasma
5. decr NO
6. decr histamine release from basophils
7. derc IgG
8. decr cytokines |
|
|
Term
| give 3 examples of corticosteroids |
|
Definition
hydrocortisone
prednisolone
dexamethasone |
|
|
Term
| natural corticosteroids in the body = |
|
Definition
| steroids secreted by the adrenal cortex |
|
|
Term
|
Definition
mineralocorticoids
glucocorticoids |
|
|
Term
|
Definition
| effect water and electrolyte balance (eg aldosterone) |
|
|
Term
|
Definition
| effect CHO and protein metab (eg hydrocortisone & corticosterone) |
|
|
Term
| glucocorticoids released is activated by... |
|
Definition
| ...ACTH secreted in anterior pituitary |
|
|
Term
| ACTH secretion is regulated by... |
|
Definition
| CRF from the hypothalamus and the levels of glucocorticoids in the blood (-feedback) |
|
|
Term
[corticosteroids] in blood in
a) the morning
b) midnight |
|
Definition
|
|
Term
| hydrocortisones used for... |
|
Definition
|
|
Term
|
Definition
| 4x more potent than hyrdrocortisone |
|
|
Term
|
Definition
...chronic dz, in a lot of pain
long term use
eg RA |
|
|
Term
| potency of dexamethasone = |
|
Definition
| 30x more potent than hydrocortisone |
|
|
Term
|
Definition
chronic dz, in alot of pain eg RA
long lasting
selective - no affinity for mineralocorticoid Rs = no effect on water balance :)
BUT side effects due to sich high potnecy! |
|
|
Term
| caffeine causes glucocorticoid levels to... |
|
Definition
|
|
Term
|
Definition
redness
heat
swelling
pain
swelling |
|
|
Term
|
Definition
wound healing and repair
proliferative actions of chronic inflam |
|
|
Term
| glucocorticoids effect early and late inflam therefor what should you give with glucocortocoids? |
|
Definition
| Adr to counteract inhibiton of healing and repair by glucocrticoids affecting late inflam |
|
|
Term
| glucocorticoids mech of action = |
|
Definition
| lipophilic = readily cross cell mb, moves to nucleus and either represses or induces gene transcription (most commonly supresses transcriptiion of genes for cytokines) |
|
|
Term
| glucocorticoids inhibit what in Tcells? |
|
Definition
| IL4 release IFNgamma release production of IL2 release of macro activating cytokines |
|
|
Term
| calcineurin inhibitors are used in conjunction with glucocorticosteroids. NAme 2 |
|
Definition
cyclosporin
tacrolimus (FK-506) |
|
|
Term
|
Definition
| binds to R in cell cytoplasm called cyclophilin = inhibit calcineurin enzyme = inhibit IL2 production = no cell prolif and no cytokine release |
|
|
Term
| side effects of cyclosporin = |
|
Definition
|
|
Term
| to prevent transplant rejection use... |
|
Definition
| ....glucocorticoids and cyclosporin |
|
|
Term
| how do glucocorticoids inhibit PLA2? |
|
Definition
| they activate lipocortin which inhibits PLA2 |
|
|
Term
| how does glucocorticoids inhibit cox2? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| clinical uses of glucocrticoids = |
|
Definition
1. oral prednisolone to tx feline asthma
2. fluticasone to tx RAO
3. eczema, rhinitis - allergic conditions
4. hypersensitivity state - give high dose dexamethasone or hydrocortisone
5. supress graft rejection with cyclosporin (a calcineurin inhibitor)
6. acute s.c. injury (methylprednisolone up to 24-48hrs fter injury)
7. Autoimmune dz - high dos prednisolone long term
8. adrenal insufficiency (not producing hydrocortisone) -tx with hydrocortisone |
|
|
Term
| signs of adrenal insufficiency = |
|
Definition
| chronic fatigue mm weakness decr appetite weight loss hyperpigmentation |
|
|
Term
| admin of glucocorticosteroids = |
|
Definition
oral
topical
parenteral
inhalers (local admin= less side effects :)) |
|
|
Term
| side effects of glucocorticoids with high dose chronic tx = |
|
Definition
1. immunosupression
2. supress endogenous glucocorticoid syth
3. metabolic actions
4. osteoporosis (bones brittle and fragile)
5. cushings dz |
|
|
