Podiatry Boards Part 2
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How are endogenous steriods released?
- Anterior Pituitary- ACTH
- Zona Fasciculata- Glucocorticoids
When are our highest levels of glucocorticoids?
Increase at night and morning
If a pt is on >7.5 mg/day of prednisone for 1 month what must you do pre-op?
Hydrocortizone 100mg IV and then some
What are the systemic affects of steriods?
- Increases gluconeogenesis
- Increases lipolysis
- Decreases protein synthesis and increases muscle breakdown
- Increases Na and H20 retention causing hypokalemia
- Decreases gut calcium absorption
- Inhibits osteoblast function
- Decreases collagen formation
- Impairs granulation tissue formation
What is the MOA of systemic glucocorticoids?
- Inhibit prostaglandin synthesis
- inhibits COX 2
- Inhibits cytokine and adhsion molecule and chemotactic factors
- Decreases vascular permeability
- increaes neutrophils but decreases accumulation at sites of inflammation
- decreases macrophages, lymphocytes and eosinophils basophils
- Inhibits LOX
- Inhibits leukotrienes
- decreases bronchiole inflammation
What are some of the Adverse affects of steriods?
- Increased appetitie
- increase infectionrisk
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