Pharmacology.block 2 Steroids

Front 1

What are the adverse effects of hypercortisolism?

Back 1

CUSHINGOID GC

Central fat
'u'phoria
skin thinning
Hair loss/growth (Hypertension)
Infections
Neg Nitrogen Balance
Gonadal dysfunction
Osteroporosis
Insomnia
Delayed wound healing (bruising)

H(igh) - high BP hypertension
G - Gordo (obese)
C - Cataracts

Front 2

Antagonist at GC receptor

Back 2

Mifepristone (RU 486)

Front 3

Antagonist at MC receptor

Back 3

Spironolactone

Front 4

Potent Mineralocorticoid analog

Back 4

Fludrocortisone

Front 5

DoC for systemic/oral treatment of inflammation as in IBD or severe asthma

Back 5

Prednisolone

Front 6

_ or _ are used to cause immunosupression (in graft pts)

Back 6

Methylprednisolone or dexamethasone

Front 7

Steroid used to treat allergic rhinitis

Back 7

fluticasone

Front 8

Steroid used to treat severe psoriasis

Back 8

Triamcinolone acetonide

Front 9

The main glucocorticoid?

Mineralcorticoid?

Back 9

cortisol

aldosterone

Front 10

Why can't cortisone and prednisone be used topically?

Back 10

11 beta hydroxysteroid dehydrogenase is needed to convert these two drugs into their active forms. It is not present in the skin.

Front 11

Antiinflammatory and immunosuppressive effects on the immune system are cheifly due what type of corticosteroids?

Back 11

glucocorticoids, not mineralocorticoid

Front 12

An excess of corticoisteroids results in (hyper/hypotension).

Back 12

hypertensions - predominately mineralocorticoids, (some gc)

Front 13

Corticosteroids Decrease the transcription and translation of _, _ and _.

But an increase in trx and trl of _

Back 13

IL-2, GM-CSF, and TNFaalpha


anti-inflammatory factors -IL10 and IkBalpha.

Overall, immune cell are impaired.

Front 14

Glucocorticoid receptors are found _.

Mineralocorticoid receptors are found _. What enzyme is present with these that deactivate cortisol?

Back 14

everywhere


in kidney. 11 beta hydroxysteroid dehydrogenase
turns hydroxyl group into ketone (opposite effect than in skin)

Front 15

In the indirect mechanism of action, The glucocorticoid/receptor complex binds to _ , which prevents it from going into the nucleus and binding to the _.

Back 15

nfkappaB

DNA

It prevents nfKappaB from binding to the DNA and triggering transcription

Front 16

too much/too little glucocorticoids is life threatening. What is this condition called?

Back 16

too little - Addison's

because of Adrenal insufficiency or abrupt withdrawal of glucocorticoids

Front 17

Patient presents N/V, abdominal pain, dehydration, weakness. BP is 80/60, blood shows hyponatremia and hyperkalemia. What is this describing?

Back 17

acute adrenal insufficiency

- due to abrupt withdrawal of glucocorticoids or stress in adrenally compromised pt

Front 18

How do you diagnose Cushings?

Back 18

dexamethasone

Front 19

_ is great for mineralocorticoid replacement

Back 19

Fludrocortisone

Front 20

What drug is given to the fetus when delivery is expected prematurely in order to stimulate lung maturation and surfactant production?

Back 20

BETAmethasone

Front 21

Hydrocortison is used for

Back 21

topical therapy (eczema)

Front 22

What corticosteroids have poor bioavailability and are rapidly metabolized by the liver, minimizing their systemic side effects? These are used in allergies.

Back 22

Beclomethasone, Budesonide, Fluticasone

Front 23

What are some unavoidable side effects from corticosteroids?

Back 23

Insomnia, increased appetite, weight gain.

Front 24

What are some delayed and insididois side effects of long term corticoisteroids?

Back 24

atherosclerosis, cataracts

Front 25

3) Jason is admitted to the hospital for a wide-spread rash. Following oral administration of prednisone his symptoms do not resolve as quickly as expected. Which one of the following is the most likely reason for the delayed effect?

Back 25

decreased liver function

Front 26

Decreased NFkappaB activities results in decreased transcription of _ and _ enzymes

Back 26

Phospholipase A2 (dec LT synthesis)

and

COX 2 (dec PG synthesis)

Front 27

Decreased transcription of CM-CSF results in decreased proliferation of _

Back 27

leukocytes

Front 28

Decreased TNFalpha signal transduction results in _

Back 28

decreased chemotaxis

Front 29

Increased IL 10 transciption results in _

Back 29

suppressing the activity of T helper lymphocytes

Front 30

Decreased AP-1 activity works (indirectly/directly)

Back 30

indirectly

AP-1targets genes for collagenase and IL2, (increases extracellular matrix remodeling functions)