Question Answer
Adrenal Cortical Hormones Chemicals secreted by the adrenal cortex, referred to as steroids.
Endogenous Refers to inside – produced by the body.
Exogenous Refers to outside – manufactured to be placed inside the body(E.G., Medication)
Immunoglobulin E (IgE) Gamma globulin that is produced by Cells in the respiratory tract.
Prostaglandin One of several hormone-type substances circulating throughout the body.
Steroids Also known as Glucocorticoids or corticorsteroids, agents that produce an antiinflammatory response in the body.
Steroid Diabetes Hyperglycemia (e.g., increased plasma glucose levels) resulting from glucocorticoid therapy; glucocorticoids break down proteins and fats to generate building blocks for gluconeogenesis.
Physiology of endogenous corticosteroids involves a sequence of stimulation of the adrenal cortex through the hypothalamic-pituitary-adrenal (HPA) axis, in which increased blood levels of corticosteroid inhibit the HPA and adrenal cortex from further secretion.
Corticosteroids are secreted By the adrenal cortex including: glucocorticoids (e.g., cortisol) mineralocorticoids (e.g., aldosterone)
Glucocorticoids often referred to simply as steroids, exert an antiinflammatory effect in the body.
What can Exogenous corticosteroids suppress? The HPA axis and the adrenal gland.
Levels of endogenous corticosteroids Follow a daily, or diurnal, rhythm.
What does inflammation produce? General symptoms of redness, swelling, heat and pain.
What mediators further amplify the inflammatory response. arachidonic acids cascade (Prostaglandins and leukotrienes); histamine; and various cytokines, such as interleukins.
Areosolize glucocorticoids all are Topically active drugs and include beclomethasone dipropionate, triamcinolone acetonide, flunisolide, budesonide, fluticasone propionate, and mometasone furoate.
Aerosol agents are available for oral inhalation in the control of asthma and COPD and intranasal administration for rhinitis.
Question Answer
Natural corticosteriods are secreted by the__________ ___________ Adrenal Cortex
Those secrete by the adrenal cortex are termed__________ hormones adrenalcorticoid
The inner zone (medulla) of the adrenal glands secrete___________. adrenaline
The outer zone (cortex) of adrenal glands secrete__________. corticosteriods
Name the three types of adrenal-corticoid hormones produced by the adrenal cortex: mineralcorticiodss,sex hormomes,gluco-corticoids
The main glucocorticoid hormone is: hydrocortizone
“Steroids” in general exert an_________ effect on the body. antiinflammatory
The posterior portion of the pituitary gland releases___________hormone(_______) into the blood stream.ACTH,in turn,stimulates the adrenal gland to secrete__________(e.g hydrocortisone) adrenocorticotropic,ACTH,glucocorticoids
Artificially raising the level of the body’s steroids can result in suppression of the__________. adrenal glands
How is “Performist” administered? SVN
What is Immunoglobin E? What role does it play in inflammation? IgE is an antibody. This antibody will attract Mast Cells and Eosinophils(cause inflammation). Once the Mast cells are sensitized it will rupture and cause degranulation.
Are there sympathetic or parasympathetic nerves in the lungs? parasympathetic
What are some of the effects of natural glucocorticocoids on bodily functions? glucogenesis(increased blood sugar),protein mobilization,fat mobilization,decreased inflammation
Te most significant side effect of treatmant with steroids is_________. adrenal suppression or HPA suppression
With systemic administration of steriods,adrenal suppression begins after only a single________.The advantage of using inhaled corticosteriods is that their use minimizes________ suppression,by minimizing the _________and________the area of treatment. (day or dose),adrenal,dosage,localizing
What is taper-dose therapy? to slowly wean a patient for str
Four categories of events that occur in inflammation are: increased vascular permeability,leukocyte infiltration,chemotaxis,phagocytosis,mediator cascade
Beclomethasone dipropionate MDI:QVAR
Triamcinolone Acetonide MDI:Azmacort
Flunisoline Hemihydrate MDI:Aerospan
Fluticasone propionate MDI:Flovent 44,110,220|DPI:Flovent Diskus 50,100,250
Budesonide DPI:Pulmicort SVN:Respules
Mometasone furoate DPI:Asmanex Twisthaler
Fluticasone propionate/Salmeterol DPI:Advair Diskus 100, 250, 500 over 50 macrograms MDI:Advair HFA
Budesonide/formoterol fumerate HFA MDI: Symbicort 80,160 over 4.5 macrograms
Two of the more significant mediators are _____________and ____________. Eosinophils and Leukocytes
Hazards and side effects of system steroids are: Supression of the natural production of natural steroids,psychiatric responses, osteoporosis,peptic ulcers,fluid retention,hypertention, increased WBC’s, and Hyperglycemia.
Steroid given IV in acute cases… Solu-Mederal (methyprednisolone)
Two side effects of aerosolized steroids.. candida and dysphonia
Trade Name Info
Beclovent Gen Nm: Belcometasone Type: Corticosteroid Admin: MDI
Azmacort Gen Nm: Triamcinolone Type:Corticosteroid Admin: MDI 100mcg 2-4puffs BID-QID
Flovent Gen Nm: Fluticasone Type: Corticosteroid Admin: MDI 44,110or220 2puffs BID 1000mcg max/day
Pulmicort Gen Nm: Budesonide Type: Corticosteroid Admin: DPI 200mcg 1-3puffs BID
Prednisone Gen Nm: Prednisone Type: Corticosteroid Admin: PO tab/liq 5-60mg/day
Medrol GenNm:Methylprednisolone Type: Corticosteroid Admin: PO tablet 4-8mg
Flovent Rotadisk Gen Nm: Fluticasone Type: Corticosteroid Admin: DPI 50,100or250 2puffs BID 1000mcg max/day
Solu-Medrol GnNm:Methylprednisolone Type: Corticosteroid Admin: IV 1-2mg Q4-6hr
Alvesco Gen Nm: Ciclesonide Type: Corticosteroid Admin: MDI 80,160mcg 160mcg QID
Decadron Gen Nm: Dexamethasone Type: Corticosteroid Admin: MDI 84mcg 2-3pufs BID,QID
Question Answer
Aerobid flunisolide
Alvesco ciclesonide
Asmanex mometasone
Azmacort triamcinolone
Beclovent/Vanceril beclomethasone
Flovent fluticasone
Pulmicort Turbuhaler/Respules budesonide
Pulmicort Flexhaler budesonide (DPI)
QVAR beclomethasone
Advair salmeterol & fluticasone
Symbicort formoterol & budesonide
Intal cromolyn sodium (asthma prophylactic)
Tilade nedocromil sodium (asthma prophylactic)
Accolate zufirlukst >5
Zyflo zileuton >12yrs
Singular montelukast >6months
Question Answer
Corticosteriods are produced by… Adrenal cortex (Kidneys)
Corticosteriod production is based on… The production of corticotropin by the hypothalamus
Corticotropin production is based on… stimulation by body stressors
What are corticosteroids? A group of chemicals secreted by the adrenal cortex
What are the three types of corticosteroids? 1. Glucocorticoids (Cortisol-antiinflammatory) 2. Mineralcorticoids (Aldosterone) 3. Sex hormones (Androgens & Estrogen)
Inhaled Corticosteroids selectively chosen COPD patients by doctor. Not recommended for wholesale use in “generic COPD”
Side affects of Systemic administration of Corticosteroids Suppression of the HPA axis-feedback system, Osteoporosis, Cushing-like appearance (moon face), Immunosuppression
Question Answer
Qvar MDI: 40 mg/ puff 80 mg/ puff
Aerobid MDI: 250mg/puff
Symbicort MDI: 80mg/puff 160mg/puff
Alvesco MDI: 40mg 80mg
Asmanex/ Twisthaler 110mg/puff 220mg/puff
Aerospan 80mg/puff
Dulera 100mg/5mg 200mg/5mg
Flovent HFA: 44mg 110mg 220mg/puff MDI: 50mg 100mg
pulmicort 90mg/actuation 180mg/actuation
Question Answer
corticosteriods have a _-_ effect anti-inflammatory
< in lymphocytes inhibits late phase inflammatory phase enhances beta-receptors stimulation anti-inflammatory effect of corticosteriods
methylprednisone (solumedrol) is given this route I.V
prednisone is given this route tablet
Dexamethasone sodium phosphate (Decadron) is given this route & and is used 4 immediate relief of upper airway inflammation I.v injection
SE of systemic corticosteroids include suppressed normal hypothalmic pituitary adrenal gland obesitey/ chusings syndron/ growth suppression/ mood changes (irratability; deppression); thinning of the skin; HTN
some systemic absorbsion occures w/ this route via mucous membranes in oropharynx aerosolized corticosteriods
aerosolized corticosteriods are dosed _ the advance to _&_ when indicated 2 control clinical manifestation of asthma BID~TID~QID
these r seen w/ this med fungal infection w/Candida Albercans or Aspergillus Niger in mouth; throught;irritation; hoarseness; dry mouth coughing inhaled corticosteriods
_ insufficiency may occur only is Pt is being weaned from systemic corticosteriods simultaneously DO NOT use inhaled TX 4 ACUTE ASTHMA ATTACK inhaled Corticosteriods may cause adrenal <
it takes 2 wks for _ steroids to produce an anti-inflammatory effect cuz it obliterates as it touches mucous membranes. so Pt needs I.V __ or tablet__ while starting inhaled steriod inhaled/ Solumedrol or prednisone
these drug need to be taken regularly 2 be effective against _ _ airway hyperactivity
Question Answer
Beclomethasone Dipropionate HFA Qvar
Flunisolide AeroBid
Fudesonide/formoterol fumarate Symbicort
Ciclesonide Alvesco
Mometasone furoate Asmanex Twisthaler
Flunisolide hemihydrate HFA Aerospan
Mometasone furoate/ formoterol funarate HFA Dulera
Fluticasone propionate Flovent
Fluticasone propionate/salmeterol Advair
Budesonide Pulmicort