S15) Steroid Pharmacology Flashcards Preview

(LUSUMA) Clinical Pharmacology & Therapeutics > S15) Steroid Pharmacology > Flashcards

Flashcards in S15) Steroid Pharmacology Deck (25)
Loading flashcards...
1
Q

Identify the different layers of the adrenal cortex

A
2
Q

Identify some different types of corticosteroids, including examples

A
  • Glucocorticoids e.g. cortisol
  • Mineralocorticoids e.g. aldosterone
  • Sex steroids
3
Q

Outline the HPA axis

A
4
Q

Identify six metabolic actions of glucocorticoids

A
  • Glycogenolysis
  • Gluconeogenesis
  • Hyperglycaemia
  • Proteinolysis
  • Lipolysis (low conc.) / lipid deposition (high conc.)
  • Redistribution of fat
5
Q

Identify five effects of glucocorticoid deficiency

A
  • Hypoglycaemia
  • Weight loss
  • Nausea
  • Hypotension
  • Underweight
6
Q

Identify five effects of glucocorticoid excess

A
  • Hyperglycaemia
  • Weight gain
  • Increased appetite
  • Hypertension
  • Cushingoid
7
Q

Identify four effects of mineralocorticoid deficiency

A
  • Hyponatraemia
  • Dehydration
  • Hypotension
  • Hyperkalaemia
8
Q

Identify three effects of mineralocorticoid excess

A
  • Hypernatraemia
  • Hypertension
  • Hypokalaemia
9
Q

Describe the pharmacokinetics for corticosteroids

A
  • High oral bioavailability (diffuse easily)
  • Metabolised by liver, eliminated by kidney
  • Hepatic and renal clearance (decreases with age)
10
Q

Identify the various different routes of administration for steroid drugs and provide an example drug for each

A
  • Intravenous e.g. methylprednisolone
  • Oral e.g. prednisolone
  • Inhaled e.g. beclomethasone
  • Topical e.g. betamethasone
  • Intra-articular e.g. triamcinolone
11
Q

Describe five effects of corticosteroids on the immune system

A
  • Inhibition of B and T cell responses
  • Reduced phagocytic function
  • Immunosuppression
  • Reduced inflammation
  • Reduced transcription of cytokines
12
Q

Briefly, describe the mechanism of action of steroid hormones

A
13
Q

What are the clinical uses of steroid drugs?

A
  • Inflammatory disease
  • Immunosuppression
  • Malignancy
  • Adrenal insufficiency
  • Cushing’s disease diagnosis
14
Q

What are the indications for corticosteroid replacement therapy?

A
  • Deficiency
  • Addison’s disease
  • Adrenolectomy
15
Q

Which drugs can be used for corticosteroid replacement therapy and what is their dosage?

A
  • Hydrocortisone (cortisol) 20 - 30 mg daily
  • Fludrocortisone (aldosterone) 50 - 300 μg daily
16
Q

Which inflammatory diseases are treated by corticosteroids?

A
  • Asthma
  • GI disease
  • Nephrotic syndrome
  • Rheumatoid arthritis
  • Inflammatory skin conditions
17
Q

Describe the use of steroids in pregnancy

A

A single course of antenatal corticosteroids is offered to women who are at risk of preterm birth (24-34 weeks of gestation)

18
Q

Which steroids are given to women at risk of preterm birth?

A
  • Betamethasone 12 mg given IM in two doses
  • Dexamethasone 6 mg given IM in four doses
19
Q

What are the side effects of mineralocorticoids?

A
  • Fluid retention
  • Hypertension
  • Hypokalaemia
20
Q

What are the side effects of glucocorticoids?

A
  • Osteoporosis
  • Avascular necrosis
  • Peptic ulcers
  • Increased infections
  • Hypertension
  • Diabetes
21
Q

Describe the Cushingoid fat distribution

A
22
Q

What are the effects of corticosteroid on bone?

A
  • Inhibition of osteoblast formation
  • Increased osteoclast proliferation
  • Reduced calcium absorption in gut
  • Reduced sex steroid production
  • Osteoporosis
23
Q

How does adrenal suppression occur?

A
  • Suppression of HPA axis occurs after 3 weeks
  • Prednisolone > 20 mg will suppress HPA axis
  • May persist for years, if long term treatment
24
Q

What precipitates a hypo-adrenal crisis?

A

Abrupt withdrawal of steroids

25
Q

What characterises a hypoadrenal crisis?

A
  • Hypotension
  • Hypoglycaemia
  • Hyponatraemia
  • Hyperkalaemia
  • Severe dehydration
  • Death, if untreated