martinezdvm's version from 2015-12-04 20:55

Section 1

Question Answer
LIST the corticosteroidsPrednisone, Prednisolone, Methyl-Prednisolone, Hydrocortisone, Flumethasone, Dexamethasone, Betamethasone, Triamcinolone
Short acting corticosteroidsHydrocortisone
Intermediate acting corticosteroidsPrednisolone, Prednisone, Methyl-prednisone & Triamcinolone
Long acting corticosteroidsFlumethasone, Betamethasone, Dexamethasone (it took a long time b4 BETH FLU 10 over the ZONE)
LIST the glucocorticoidsAcetate & Fludrocortisone

Section 2

Question Answer
Which corticosteroid is used to tx ADDISONs DZ?Dexamethasone (it took 10 to get over the ADD)
Which GLUCOCORTICOID is used to tx ADDISONs in SMALL animals? (2)Acetate & Fludrocortisone
three division of the adrenal cortex & which hormones arise from them?Z. fasciculata = glucocorticoids, Z. reticularis = androgens, Z. glomerulosa = mineralocorticoids
The medulla of the adrenal gland secretes?Catecholamines
Glucocorticoids lead to what CNS effects?Excitation & Euphoria
Blood parameters affected by glucocorticoids?(1) Polycythemia (increased RBCs), (2) increased neutrophils (released from bone marrow) & (3) increased platelets. We will also see reduced lymphocytes, Eosinophils, Basophils & monocytes.
CVS effects of glucocorticoids?tachycardia, increased inotropic effects, hypertension
Resp syst effects w glucocorticoids?bronchoDILATION- occurs due to increased number of Beta 2 receptor expression
Which corticosteroid has anti-inflammatory effects?glucocorticoids
Describe the anti-inflammatory effects of glucocorticoids? Anti-inflammatory effects: result from decreased mast cell retention; decreased histamine release. Mechanism: (4 steps) (1) decrease in IL-8 (chemo-attractive factor or adhesion factor), (2) decreased PLA2 or arachidonidate formation is reduced (3) decreased autacoid (histamine) release from mast cells & (4) decreased proteolytic enzymes.
Which group of corticosteroids leads to muscle weakness/wasting @ high doses ? glucocorticoids
how do glucocorticoids affect hair & skin?ALOPECIA
T or F: are glucococorticoids needed to maintain muscle function?YESSSS
What happens to the muscles if glucocorticoid levels are low?if levels are low we see muscle weakness
Do mineralocorticoids have any effect on your skeletal m?YES: when mineralocorticoids levels are high they lead to muscle weakness due to HYPOKALEMIA
Which drug stimulates glucoNEOgenesis & glycoGENESIS?Cortisol (glucocorticoids)
What happens when glucocorticoids are EXCESSIVE?hyperglycemia
Glucocorticoids do what to proteins in the liver?stimulates protein genesis
Glucocorticoids on extra hepatic tissues?  Induces proteolysis in extrahepatic tissues (provides amino acids for gluconeogenesis in the liver)
Do Glucocorticoids stimulate PU/PD?Yes: reduced ADH/Vasopressin secretion
Glucocorticoids will induce secretion of PTH, why?Causes low reabsorption of Ca+2 in kidneys & GI, leading to increase PTH
Why should you not stop glucocorticoid administration abruptly?will lead to addison's disease (Mech: glucocorticoids result in a decrease in the secretion of ACTH from the pituitary & leads to feedback inhibition. )
Mineralocorticoid's effect on water?Leads to water retention/conservation
Mineralocorticoid's effect on calcium? Increases Ca+2 levels in the myocardium (CVS)
Prevalence of PDH in dogs? (%)85%
Prevalence of adenomas in dogs?15%
Another name for Cushing's?HYPERadrenocorticism
Another name for Addison's ?HYPOadrenocorticism
What part of the adrenal gland is affected in Addison's?all parts of the adrenal CORTEX
precursor for the 5 classes of steroid hormones?Cholesterol
Corticosteroid side effects: (9 total): Increased susceptibility to infection & decreased wound healing; GIT ulceration; Myopathies; edema (resulting in fluid & electrolyte imbalance); diabetes mellitus; abortion; laminitis in horses; hepatotoxicity
ACTH & Cortisol are released from?hypothalamic pituitary adrenal axis.
Elevated cortisol levels exert negative feedback on??CRH (corticotropin releasing hormone) & ACTH.
f Succinate, Phosphate & Polyethylene glycol are found in a bottle of injectable drug, these are indicative of??IV injection (getting an IV injection SUCks PHO' POLY)
If Acetate & Pivolate are found in a bottle of injectable drug, this is indicative of??SubQ & IM (when u give an IM make sure ACE PIVOTs the needle)
What do the structure of corticosteroids impart?glucocorticoid action & duration of action
What the bonds that impart corticosteroid action:4,5-delta- & 3- keto
What the bonds that impart glucocorticoid action:17 α(alpha)- OH & 11β (beta) (11 BETA fish & 17 alphas got stressed)
What is the duration of action of GLUCOCORTICOIDS influenced by?(1) percentage of drug bound to plasma protein, (2) Affinity the drug has for enzymes involved in their metabolism, (3) Lipophilicity of the drug & (4) Affinity for the glucocorticoid receptor

Section 3

Question Answer
List the steroid inhibitors?Mitotaine, Ketoconazole, Selegiline & Trilostane (Mi Ken doll SELLs 3 steroids at the STOP!)
Which steroid inhibitor irreversibly destroys the cells of Zona fasciculata (glucocorticoids) & zona reticularis (androgens)?Mitotaine
Which steroid inhibitor INHIBITS steroid synthesis reversibly by blocking cytochrome p450 enzyme?Ketoconazole
Which drug is FDA approved for tx of CUSHINGs and Cognitive dz (old age dementia) in dogs?Selegiline
Which steroid inhibitor inhibits ACTH secretion?Selegiline
Trilostaine reversible or irreversible? Mechanism:Reversible: reduces synthesis of Cortisol, aldosterone & androgens by competitively inhibiting 3-beta hydroxysteroid dehydrogenase (he TRIed to be like the STEROIDS so much he COMPETED w them)
Which steroid inhibitor is an antifungal drug?Ketoconazole
Side effects of ketoconazoleGI/Repro side effects + several drug interactions

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