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13 Cards in this Set
- Front
- Back
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Name glucocorticoids with short duration of action
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Hydrocortisone and cortisone
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Name glucocorticoids with intermediate duration of action
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Prednisolone, methylprednisolone
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Name glucocorticoids with long duration of action
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Betamethasone, dexabetamethasome
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Name glucocorticoids that are only used locally
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Fluticasone and budesonde
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What are the effects of glucocorticoids?
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- Decreased glucose uptake and use- Decreased protein synthesis- Increased protein breakdown- Increased ketone body synthesis- Increased lipolysis- Induces anti-inflammatory genes- Decreased leukocyte migration- Decreased capillary permeability and vasodilation.- Osteoporosis
- Spillover-mechanism, causing Na+ retention and K+ loss |
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What are the indications of glucocorticoid use?
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- Substitution therapy for adrenal insufficiency, Addison's disease
Systemic acute symptomatic therapy:- Allergic reactions/anaphylaxis, asthma attack, acute exarcerbation of autoimmune diseases or COPD. Systemic chronic symptomatic therapy:- Asthma, COPD, IBD, sarcoidosis, Sjogren, SLE, Rhematoid arthritis - Local symptomatic treatment in skin, eyes, ears. - Organ transplant |
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Why do patients who use hydrocortisone/cortisone increase their dose during periods of stress, surgery and trauma?
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They can develop adrenal crisis since the body requires more cortisol during peroids of stress. It can be fatal
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Why should long-term use (> 3 weeks) of corticosteroids be terminated gradually?
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Long-term use causes atrophy of the adrenal cortex. If it is discontinued suddenly, the body will experience cortisol deficiency, potentially an adrenal crisis.
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Why do synthetic glucocorticoids act more rapidly than the endogenous ones?
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Most of the endogenous glucocorticoids bind to a transport protein, Corticosteroid-binding globulin (CBG). Synthetic glucocorticoids dont bind to CBG and there act more rapidly.
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What are the side effects of long-term treatment with corticosteroids?
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- Skin atrophy- Purple stretch marks- Hypertension- Central weight gain, moon face- Hyperglycemia/diabetes- Osteoporosis- Muscle weakness
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Contraindications for glucocorticoid treatment?
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Allergy, systemic fungal infections and live virus vaccine
Should be used with care in pregnant women, psychosis, diabetes. |
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What are the indications for treatment with mineralocorticoids? Name the drugs
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"Used only in substitution therapy for Addisons disease and congenital adrenal hyperplasia (21b deficiency).
Treated with fludrocortisone and cortisol." |
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Which drugs are used to inhibit cortisol synthesis and how?
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Metyrapone - inhibits 11b-hydroxylase.
Ketoconazole - inhibits 17a-hydroxylase. Used for Cushings syndrome therapy. |
