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Rx2013
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Adrenocorticoid Production
hypothalamus => anterior pituitary => ACTH acts on Adrenal Cortex => Cortisol
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Effects of glucocorticoids on metabolism
- stimulaiton of gluconeogenesis
- mobilization of amino acids from extra hepatic tissue
- inhibition of glucose uptake in muscle and fat
- stimulation of fat breakdown
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Effects of glucocorticoids on inflammation and immune function
potent anti-inflammatory & immunosuppressant
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Disease states associated with glucocorticoids
- Cushing's disease
- Addison's disease
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Hyperadrenocorticism
- cushing's disease
- excessive endogenous cortisol production
- administer glucocorticoids for therapeutic purposes
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Hypoadrenocorticism
- Addison's disease
- result of infectious disease or autoimmune destruction of the adrenal cortex
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Dexamethasone
- synthetic glucocorticoids
- anti-inflammatory/immunosuppressant
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Signs of dexamethasone overdose
- retinal toxicity
- glaucoma
- subcapsular cataract
- GI bleed
- pancreatitis
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Hydrocortisone
- most important human glucocorticoid
- essential for life
- regulates/supports CV, metabolic, immunologic and homeostatic functions
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Indications for hydrocortisone
relief of inflammatory and pruritic manifestations of dermatoses
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Mechanism of action for hydrocortisone
binds to the cytosolic glucocorticoid receptor
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ADEs with hydrocortisone
- inhibition of bone formation
- suppression of calcium absorption
- delayed wound healing
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Prednisonlone
synthetic glucocorticoid
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Prednisonlone indication
- primary or secondary adrenocortical insufficiency
- psoriatic arthritis
- arthritis
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Prednisonlone mechanism of action
- inhibits leukocyte infiltration at the site of inflammation
- interferes with mediators of inflammatory response
- suppress humoral immune responses
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ADEs with prednisolone
- high blood glucose levels
- fluid retention
- cushing's syndrome
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all glucocorticoids are contraindicated in
systemic fungal infections
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Methylprednisolone indications
- 1' or 2' adrenocortical insufficiency
- congenital adrenal hyperplasia
- non suppurative thyroiditis
- hypercalcemia associated with cancer
- dermal conditions
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