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50 Cards in this Set

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What are the types of corticosteriods?
glucocorticoids (cortisol)
mineralocorticoids (aldosterone)
androgens (testerone, estradiol)
What are the fxn of glugorticoids?
fat metabolism
Carb metabolism
protien metabolism
anti-inflamatory
immunosuppressive
How do glucocorticoids work as anti-inflammatroy?
stabilization of the leukocytes lysosomal membrane
preventing the release of substances that promote inflammation
inhibition of macrophage accumulation in inflamed areas
reduction of capillary wall permeability and edema formation
How do glucocortoids help suppress the immune response?
reduce activity of lymphatic system
lymphocytopenia
decreased immunoglobin production
inhibition of antibody response
How do glucocortoids help the hematologic effects?
increased production of erythrocytes
How do glucocortoids help with protien catabolism?
mobilization of amino acid from muscle
How do glucocortoids help with glucose metabolism?
gluconeogenesis
decreased glucose utilization by cells
increased liver glycogen stores
How do glucocortoids help with fat redistribution?
mobilie fatty acids from adipose tissue
increased cellular oxidation of fatty acids
How do mineralocortoids help with fluid and electrolyte balance?
enhanced renal tubular reabsorption of NA and H20
increased urinary loss of K and H
What are the AE of corticosteriods?
adrenal suppression, muscleskeletal, suppression of immune response, endocrine, fluid and electrolyte disturbances, ocular,m gastrointestinal, CNS, dermatological, hypersensitivity, & cardiovascular
What are the therapuetic uses of corticosteriods?
endocrine disorders, rheumatic disorder, dermatologic disorder, allergic conditions, ophthalmic disorder, neoplastic disease, Gi disease, respiratory disease, and immunosuppresssion
How do glucocorticoids work as anti-inflammatroy?
stabilization of the leukocytes lysosomal membrane
preventing the release of substances that promote inflammation
inhibition of macrophage accumulation in inflamed areas
reduction of capillary wall permeability and edema formation
How do glucocortoids help suppress the immune response?
reduce activity of lymphatic system
lymphocytopenia
decreased immunoglobin production
inhibition of antibody response
How do glucocortoids help the hematologic effects?
increased production of erythrocytes
How do glucocortoids help with protien catabolism?
mobilization of amino acid from muscle
How do glucocortoids help with glucose metabolism?
gluconeogenesis
decreased glucose utilization by cells
increased liver glycogen stores
What are the precautions with corticosteroids?
pregnancy, lactation, children, & pt with signs of infection, injury or recent surgery
How do glucocorticoid help with redistribution of fat?
mobilization of fatty acids from adipose tissue
increased cellular oxidation of fatty acids
How do mineralocorticoid work?
enhance renal tubular reabsorption of NA and H20
increased urinary loss of K and H
What are the therapetic uses of corticosteriods in the endocrine system?
adrenocorticol insufficiency
congenital adrenal hyperplasia
thyrioditis
What are the therapetic uses of corticosteriods with rheumatic disorders?
rh arthritis
acute gouty arthritis
systematic lupus erthematosus
ankylosing spondylitis
dematomyoxitis
polymyositis
polyarteritis nodosa
relapsing polychodritis
What are the therapetic uses of corticosteriods with dermatologic disease?
severe dermatitis
steven johnson syndrome
uncontrollable eczema
severe psoriasis
What are the therapetic uses of corticosteriods with allergic conditions?
contact dermatitis
drug allergy
serum sickness
angioedema
What are the therapetic uses of corticosteriods with opthalmic disorders?
allergic conjunctivitis
keraitis
iritis
optic neuritis
herpes zoster opthalmicus
What are the therapetic uses of corticosteriods with neoplastic disease?
leukemias
lymphomas
What are the therapetic uses of corticosteriods with GI diseases?
ulcerative colitis
Crohn's disease
What are the therapetic uses of corticosteriods with respiratory ddiseases?
bronchial asthma
status asthmaticus
COPD
What are the therapetic uses of corticosteriods with immunosuppression?
prevent rejection of transplanted organs
autoimmune disorders
hematologic disorders
What are the UNLABELLED therapetic uses of corticosteriods?
n/v
septic shock
spinal cord injury
muscular dystrophy
What are the adverse effects of corticosteriods on the adrenal system?
endogenous suppression
rapid withdrawl cause n/v/fatigue hypoglycemia, myalgia, fever, dizziness, fainting, arthralgia
How do you manage glutocorticosteriods?
taper off-- every other day
What are the adverse effects of corticosteriods on the musculoskeletal system?
muscle wasting and weakness
osteoporosis
vertebral compression fractures
spontaneous bone fractures
NEED BONE SCANS with PROLONGED THERAPY
What are the adverse effects of corticosteriods on the immunion system?
increased suseptibility to infection and masks the signs of infection
manage with antibiotic therapy & virus vaccines
fungal infection of mouth and throat
MANAGE- antifungal txnment
What are the adverse effects of corticosteriods on the endocrine system?
cushing (moon face)
growth suppression
amenorrhea
hyperglycemia
increase DM
MANAGE by detary and anti diabetic therapy
What are the adverse effects of corticosteriods on the fluid and lytes system?
edema
hypokalemia
alkalosis
hypertention
CHF
MANAGE - NA restriction, K supplement, & diuretics
hypocalemia
MANAGE- CA supplement
What are the adverse effects of corticosteriods on the occular system?
cataracts
increased intraocular pressure
MANAGE- Routine eye exams
What are the adverse effects of corticosteriods on the gastrointerinal system?
pancreaititis
ulcerative esophagitis
peptic ulceration
MANAGE- consider prophylactic anti ulcer therapy
What are the adverse effects of corticosteriods on the CN system?
mental disturbances - mood wings
headache, vertigo, insomnia, seizures
ICP
What are the adverse effects of corticosteriods on the dermatologic system?
impaired wound healing - skin atrophy,acne
hirsutism
petechiae adn ecchymoses
What are the adverse effects of corticosteriods on the hypersensitivity?
allergic dermatitis and hives
itching and burning
What are the adverse effects of corticosteriods on the cardiovascular system?
hypo K
hypertension
intervascular thrombosis, TEmbo, FE
LV wall rupture after MI
MANAGE - monitor cardiac system
What are the precautions of corticosteriods in pregnant women?
cross barrier
can cause cleft palate and decreased fetal size
What are the precautions of corticosteriods with lactation?
supress growth in infants
and decrease endogenous corticosteriods production
What are the precautions of corticosteriods in children?
impaired growth
prolonged development
What are the precautions of corticosteriods in general?
anyone with infection
post MI
systematic fungal infection
viral or bacteral infection
hypersensitivity
peptic ulcer disease
What are the short acting glucocorticoid?
cortisone
hydrocorticsone
What are the intermediate acting glucocorticoid?
prednisone
prednisolone
triamcinolone
methylpredisolone
What are the long acting glucocorticoids?
dexamethasone
betamethasone
When should glucocorticoids be administered....
before 9:00 am
What is alternate day therapy with glucocorticoids?
double the usual dose is given every other day with intermediate acting the goal is decrease negative symptoms