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35 Cards in this Set
- Front
- Back
therapeutic consquences of steroids
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delayed onset of action
prolonged drug effect |
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anabolic actions of adrenal steroids
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stimulate gluconeogeneis
increase serum glucose |
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catabolic actions of adrenal steroids
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proteins --> AAs
stimulate lipolysis |
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adrenal steroids and electrolyte balance
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impairs calcium absorption
sodium retention and potassium excretion |
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adrenal steroids and the immune system
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decrease infiltration by lymphocytes
inhibit phag. by macs delayed hypersensitivity rxns decreases lymph and thymocyte prolif |
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synthetic corticosteriods vs. those found in body
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synthetic have longer half-lives and higher affinities at target tissue receptors
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predinsone must be administered this way
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orally
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actions of cortisol and cortisone
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anti-inflammatory and salt-retention
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triamcinolone acetonide
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very potent topical steroid used to treat asthma
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dexamethasone and betamethasone
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very potent anti-inflammatory drugs used to treat cerebral edema
seldom used as it is difficult to control |
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fludrocortisone
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very potent salt-retention steriod
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adverse effects on cardio and renal systems
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salt retention
HTN edema hypokalemia |
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adverse effects on musculoskeletal system and skin
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myopathy
osteoporosis growth retardation in children prolonged wound healing |
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adverse effects on eyes and immune system
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increased intra-ocular pressure
immunosuppression |
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metyrapone
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inhibits 11-beta-hydroxylation of steroids preventing formation of cortisol and corticosterone
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glutethimide
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inhibits conversion of cholesterol to 20-alpha-hydroxycholesterol
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mifepristone
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potent antiglucocorticoid
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spirnolactone
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antagonist at mineralocorticoid and androgen receptors
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eplerenone
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aldosterone antagonist
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thyroid hormone production steps targeted in drug therapy
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blockage of iodide active transport by ionic inhibitors
inhibition of peroxidase by thionamides iodide trapping and storage of iodiniated thyroglobulin in the thyroid allows for radiation therapy inhibition of deiodination of T4 to T3 |
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powdered thyroid gland
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inexpensive
dosage control difficult hyperallergenicity |
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levothyroxine sodium
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easily controlled
hypoallergenic once-daily dosing |
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liothyronine
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chemically pure T3
cardiotoxicity multiple dosings |
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liotrix
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4:1 ratio of T4:T3
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Thionamides
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propylthiouracil
methimazole |
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thionamide MOA
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inhibit thyroid peroxidase
prevent iodination of tyrosine on thyroglobulin block of iodotyrosine coupling blocks deiodination of T4 to T3 |
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once daily dosing for methimazole because
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it accumulates in the thyroid
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SEs of thionamides
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minor: rashes, fever, vasculitis, arthralgia, jaundice, hepatitis
agranulocytosis can occur (0.5%) hypothyroidism after prolonged use |
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thiocyonate and perchlorate
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block uptake of iodide
|
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perchlorate use
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only as diagnostic agent of thyroid function
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Iodide
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inhibits T3/4 synthesis and release
decreases size and vascularity of thyroid gland rapid acting not suitable for long-term treatment of hyperthyroidism |
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131-I
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only radioactive iodine used for treatment of hyperthyroidism
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123-I
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diagnosis only
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disadvantages of using radioactive Iodine to treat hyperthyroidism
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high incidence of delayed hypothyroidism
possible carcinogen crosses placenta |
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ophthalmopathy in hyperthyroidism
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present in graves disease
not seen in toxic nodular goiter |