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HuskerDevil
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Mineralocorticoid (MC)
- Na+ retaining
- Increased Na+ = increased H20 = increased volume
- Endogenous = aldosterone
- Synthetic = fludrocortisone
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Glucocorticoid (GC)
- Glucose retaining
- Endogenous = cortisol
- Regulation of fat, carbs, protein metabolism
- Naturally occurring = hydrocortisone and cortisone
- Synthetic = prednisone
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Corticosteroid: Mechanism of action
Intracellular binding leads to DNA transcription--> effect lags behind dosage (takes a while to elicit a response)
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GC decreases inflammation and immune response by:
- Inhibiting macrophage accumulation in inflamed areas
- Decreased capillary permeability and edema formation
- Antagonize histamine activity
- Decrease immunoglobulins and passage of immune complexes via basement memb
- Prevent release of destructive acid hydrolases from leukocytes
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Fentanyl
- Opioid agonist:
- Duragesic
- Fentora
- Actiq
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Hydrocodone/Acetaminophen
- Opioid agonist:
- Vicodin
- Lorcet
- Lortab
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Methadone
- Opioid agonist:
- Dolophine
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Morphine
- Opioid agonist:
- MS Contin
- Oramorph
- Kadian, Avinza
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Oxycodone/acetaminophen
- Opioid agonist:
- Percocet
- Endocet
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Propoxyphene/acetaminophen
Darvocet
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Buprenorphine/Naloxone
- Opioid Partial Agonist/Antagonist:
- Suboxone
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Tramadol
- Centrally acting analgesic:
- Ultram
- Ryzolt
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Methylprednisolone
- GC:
- Medrol
- Depo-Medrol
- Solu-Medrol
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Cortisone/ Hydrocortisone
- GC:
- Short acting
- T1/2 8-12 hrs
- Na+ retaining
- No anti-inflammatory
- Equiv=25mg / 20 mg
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Prednisone: Prednisolone
- GC:
- Intermediate acting
- T1/2 18-36 hrs
- Moderate Na+ retaining (1)
- Mod anti-inflamm (4)
- Equiv=5mg
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Triamcinolone
- GC:
- Intermediate acting
- T1/2 18-36 hrs
- No Na+ retaining
- Moderate anti-inflamm (5)
- Equiv=4mg
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Methylprednisolone
- GC:
- Intermediate acting
- T1/2 18-36 hrs
- No Na+ retaining
- Moderate anti-inflamm (5)
- Equiv = 4mg
- Dosepak (TAPER)
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Dexamethasone / Betamethasone
- GC:
- Long-acting
- T1/2 36-55 hrs
- No Na+ retaining
- HIGH anti-inflamm (20-30)
- Equiv=0.75
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CYP 450 enzyme induction
Decreased substrate in blood (drug removal)
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CYP 450 enzyme inhibition
Increased substrate in blood (no breakdown)
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P-glycoprotein (P-gp)
- Efflux transporter
- Excretion (decreased absorption)
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