• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/24

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

24 Cards in this Set

  • Front
  • Back
excess adrenal hormones?
cushings
adrenal hormone deficient
addisons
mineralocorticoids?
stim Na+ absorption, K/H secretion, regulation of renin angiotensin system
Fludrocortisone
used for autoimmune insufficiency and orthostatic hypotension.
can lead to overload of Na and fluids
TYpes of glucocorticoids***
????
purpose of adrenal steroids?
maintains BP and ability to vasoconstrict, supports function of skeletal muscle, mood, excitability,"", response to stress, lung development
Major effects of adrenal steroids?
Carb metabolism: promotes glucose availability
Protein metabolism: mobilization of AA
fat metabolism: accumulates and moves centrally
mineral metabolism: na retention and k excretion
Replacement therapy for addisons?
hydrocortisone (DOC), cortisone)
why does secondary adrenal insufficiency only glucocorticoids?
the primary problem is not in the adrenal gland so the renin/angiotensin system is preserved
what do you tx cushings with?
ketoconazole, aminoglutethamide
Effects of glucocorticoids?
sequesters lymphcytes and monocytes which decreases inflammation
inhibits adhesion of neutrophilsto endothelium
inhibits macrophage processing antigens (low b/t cell)
inhibits lymphokins and arachodonic acid metabolism
indications for steroids?
croup, pneumocytis carinii pneumonia, hyperthyroidism, pain management, bacterial meningitis, rheumatiod arthritis, asthma, neoplasm,
adverse effects of steroids?
depression, mania, euphoria
cataracts, myopathy, decreased uptake of glucose, osteoporosis, HTN, CHF, ulcers, pancreatitis, inhibits prostaglandins, adrenal insufficiency, suppresses host defense
T/F creams/lotions are more potent than ointments/gels?
False
what can increase the absorption of topical steroids?
high skin temp, hydration, high body surface to weight ratio (baby), occlusive dressing
what is potecy of steroids determined by?
the affinity for nuclear receptors
adverse effects of topical steroids?
atrophy, bruising, irritation, masks signs of infx, cataracts, glaucoma, worsening of dz
when should you take steroids?
morning
drug interactions of glucocorticoids?
thiazide and loops can cause hypokalemia
NSAID combo can increase gastric ulceration
blunts the effect of insulin and oral agents
may decrease the immune system (vaccines, live)
do you need to taper supraphysiological doses?
not if they are given for a short period. if chronically used taper over greater than or equal to 2 mo to allow pit/adrenal gland to respond
how much do you taper?
2.5 -5 mg prednisone eq weekly until 5 mg dose reached
what can happen with rapid withdrawal?
headache dizzy, lethargic, fever, hypoglycemia
How to avoid HPA suppression?
use short acting lose (prednisone/hydrocort), use topical, inhaled, intra-articular, intra-ocular, give entire dose in morning, switch alt day dosing, limit the length of therapy,
T/F you chould switch to another class before up'n the dose of steroids?
True