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25 Cards in this Set
- Front
- Back
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What are the 2 categories of corticosteroids?
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1. Mineralocorticoids – affect electrolyte and fluid imbalance
2. Glucocorticoids – affect carbohydrate metabolism. |
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What are the physiological actions of corticosteroids?
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1. Fluid homeostasis – mineralocorticoids
2. Increase gluconeogenesis 3. Decrease protein synthesis 4. Increase lipolysis with release of glycerol and free FAs 5. Maintain microcirculation and normal vascular permeability 6. Development of pulmonary surfactant in near-term fetus |
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Under what conditions are glucocorticoids administered?
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**Endocrine – replacement therarpy (Addison’s)
* Shock therapy – controversial * Antiinflammatory & antiallergic indications * Immunosuppressive therapy * Immune mediated dzs |
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What are the 3 Indications not accepted for use of glucocorticoids?
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o Laminitis
o Snake bite o Lack of appetite |
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What are the genomic MOAs of glucocorticoids?
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*** Cytosolic glucocorticoid receptor (cGCR) translocates to nucleus***
* Inhibits pro-inflammatory transcription factors (NF-Kappa B, STAT) * Suppresses transcription of inflammatory genes (IL-2, IL-1) * Induces transcription of immunosuppressive genes (lipocortin 1) • Inhibits AA metabolism |
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What are the non-genomic MOAs of glucocorticoids?
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* Non-genomic effects associated with cGCR
* Non-genomic effects associated with membrane-bound GCR * Non-genomic, non-specific effects caused by interactions with cellular membranes |
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What are some adverse effects of glucocorticoids?
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* HPAA suppression (why we do EOD tx, tapering, short term usage)
* Thin skin, potbelly, cushingoid apperarance, fluid retention, weight gain, muscle wasting, Na+ retention, K+ loss * Can induce parturition in last trimester; potential for congenital abnormalities |
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What are some contraindications when using glucocorticoids?
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* For jt. Injection – fracture, infection
* For all routes of admin – Corneal ulcers, GI ulcers, Hyperadrenocorticism, Infections (esp. w/immunosuppressive doses) – uncontrolled bacterial, viral, systemic mycotic, TB |
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What glucocorticoids have a short duration of action (<24hrs)?
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* Hydrocortisone
* Cortisone * Prednisone * Prednisolone * Methylprednisolone |
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What glucocorticoid has an intermediate duration of action (24-48hrs)?
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Triamcinolone
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What glucocorticoids have a long duration of action (>48hrs)?
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* Flumethasone
* Dexamethasone * Betamethasone |
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What glucocorticoids have the greatest mineralocorticoid effects?
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* Hydrocortisone
* Cortisone (Prednisone, Prednisolone, Methylprednisolone have some mineralocorticoid effects) |
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What glucocorticoids have no mineralocorticoid effects?
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* Triamcinolone
* Flumethasone * Dexamethasone * Betamethasone |
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What glucocorticoids have the greatest efftect on HPAA suppression?
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* Flumethasone
* Dexamethasone * Betamethasone (All GCCs have some HPAA suppression, but it increases as the duration of action of the drug increases) |
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What glucocorticoids have the least efftect on HPAA suppression?
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* Hydrocortisone
* Cortisone * Prednisone * Prednisolone * Methylprednisolone (All GCCs have some HPAA suppression, but it increases as the duration of action of the drug increases) |
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What is the difference between glucocortidoids and mineralcorticoids?
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** Glucocorticoids have important roles in regulating blood glucose via metabolism of carbohydrates, proteins, and fats, maintenance of microcirculation, and in development of fetal pulmonary surfactant.
** Mineralocorticoids are involved in fluid homeostasis, with increased aldosterone leading to sodium retention, potassium excretion, and proton excretion |
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What glucocorticoids are able to be give on alternate days?
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* Cortisone (not ideal)
* Prednisone * Prednisolone * Methylprednisolone |
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What are the 3 new glucocorticoids?
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* Budenoside – oral for IBD
* Ciclesonide – not common * Fluticasone – nasal spray |
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Glucocorticoid role in immune mediated disease treatment?
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* Affect neutrophil trafficking (decreased adhesion, increased circulation)
* Suppress macrophage function * Lower lymphocyte activity especially T-cells |
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What is the most commonly used glucocortiod(s) used in cattle?
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**Dexamethasone (injection)**
Use – anti-inflammatory, induce abortion/parturition |
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What is the most commonly used glucocortiod(s) used in cats?
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methylpredisolone, prednisolone
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What is the most commonly used glucocortiod(s) used in dogs?
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Prednisone
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What is the most commonly used glucocortiod(s) used in horses?
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Dexamethasone, Methylprednisolone, Triamcinolone (last 2 –antiinflammatory jt injections)
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What increases the duration of action of a glucocorticoid?
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Esterfication of alcohol C-21 increases duration
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When do you use a low, high, and very high dose of glucocorticoids?
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Low: Anti-inflammatory
High: Immunosuppressive Very-High: Shock Therapy |
