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