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15 Cards in this Set
- Front
- Back
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Corticosteroids are useful in what types of inflammatoin
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- acute
- delayed - chronic (NSAIDS only good for acute) |
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Corticosteriods to know for exam: BBDFHMPT
all end in "one" |
- beclomethasone
- betamethasone - dexamethasone - fluticasone - hydrocortisone - methylprednisolone - prednisone - trimcinolone |
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Cortisol physiologic actions
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- activates stress response
- activates cluconeogenesis and hyperglycemia - Activates catabolism of proteins and lipids - maintains vascular permeability - maintains vascular contractility |
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Pharmalogical actions of cortisol
- only seen at high doses |
- anti-inflammatory actions
- immunosuppressive actions |
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Limitations of natural and synthetic corticosteroid drugs
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- metabolic effects
- sodium retention - plasma protein binding - metabolism |
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Inhaled corticosteroid benefits
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- decreased airway inflammation and hyper-reactivity
- good local control |
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Inhaled corticosteriods
toxicity |
- oropharyngeal candidiasis
- potential systemic toxicity when swallowed -*minimize systemic toxicity by rapid metabolism in liver |
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Anti-inflammatory agents of Corticosteroids
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- CS inhibit both the PLA2 and the COX-2
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Glucocorticoids prevent tissue destruction associated with inflammation by:
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- inhibiting activation of t-lymphocytes and macrophages
- inhibiting consequent secretion of the nonlysosomal proteolytic enzymes |
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Systemic toxicity of corticosteroid
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- gluconeogenesis =diabetes
- catabolism of protein = osteoporosis, muscle weakness, poor wound healing, poor tissue repair - susceptibility to infection - Gastric ulcers - cataracts - growth suppression - psychosis |
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Local toxicity of corticosteroid
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- susceptibility to infection
- poor wound healing |
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Cushings disease is ...
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- excessive action of cortisol
- Iatrogenic = drug induced |
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Iatrogenic Adrenal Insufficiency
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- long-lasting nature of adrenal-pituitary suppression due to adrenal atrophy
- insufficiency can be induced by low doses due to negative feedback inhibition of pit.-adrenal function |
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Tx of iatrogenic adrenal insufficiency
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- symptoms: decreased response to stress and hypotensino and shock
- 20mg/day prednisone for 1 month |
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Dose scheduling for corticosteroids (2 types)
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- tapering = after thrapeutic response achieved, then a gradual reduction over 2-3 wks: prevents flare of inflammaroty process
- alternate day= reduces side effects in pts with long-term therapy, can preven adrenal-pituitary suppression |
