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Pharmacology Tutorials - Endocrinology II

Pharmacology Tutorials - Endocrinology II

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Published by Abialbon Paul

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Published by: Abialbon Paul on Jun 13, 2012
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12/24/2012

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Endocrinology Tutorials II
-Adrenal corticosteroids-Drug affecting calcium balance-Androgens & anti-androgens-Estrogens-Progestins-Contraceptives-Oxytocin & tocolytics- Vasopressin
 
CORTICOSTEROIDS1.
 
Classify Glucocorticoids.
Short ActingHydrocortisoneIntermediate actingCortisonePrednisoloneMethylprednisoloneTriamcinoloneLong actingDexamethasoneBetamethasone
2.
 
What are the metabolic actions of Glucocorticoids?
Carbohydrates: decreased uptake and utilisation of glucose accompanied byincreased gluconeogenesis; this causes a tendency to hyperglycaemia.Proteins: increased catabolismLipids: a permissive effect on lipolytic hormones and a redistribution of fat
3.
 
How do glucocorticoids mediate the anti-inflammatory and immunosuppressiveaction?
Induction of Lipocortin in macrophages & endotheliumReduction in COX2 levelsReduction of expression of genes for cytokinesReduced production of acute phase reactantsAffects leukocyte functions
4.
 
What are the advantages of prednisolone over hydrocortisone?
Four times more potentNo fluid retentionLess pituitary-adrenal axis suppression when alternative day regimen is given
5.
 
What are the uses of Glucocorticoids?
Replacement uses:Acute adrenal insufficiency
Addison’s disease
 Congenital adrenal hyperplasiaThyroid stromImmunosuppression:Inflammatory arthritisCollagen vascular diseasesAllergic reactionsAutoimmune diseasesBronchial asthmaRetrobulblar neuritis, keratitis
 
Transverse myelitis
Ulcerative colitis, Crohn’s dise
aseOrgan transplantationSteroid dependant nephrotic syndromeSeptic shockOther uses:Cerebral edemaPremedication in cancer therapy
6.
 
Name the diagnostic use of glucocorticoids.
Dexamethasone is used in the dexamethasone suppression test useful in thediagnosis of Cushing syndrome.
7.
 
How do glucocorticoids benefit Preterm labour?
Glucocorticoids induce fetal lung maturity, decrease interventricularhaemorrhage and decreases the risk of necrotising enterocolitis associatedwith preterm labour.
8.
 
Name the infections where glucocorticoids are used under antibiotic cover?
TB meningitis, Lepra reactions, Severe pyogenic meningitis, Pneumocyctiscarini & neurocysticercosis
9.
 
What are the side effects of glucocorticoid therapy?
Fluid retentionCushingoid syndromeHyperglycemiaAvascular necrosis of femurPosterior subcapsular cataract(Systemic therapy)Glaucoma (Topical therapy)Growth retardationOsteoporosisMuscular weaknessPeptic ulcerationDelayed wound healingSusceptibility to infection
10.
 
Describe cushingoid habitus?
(refer diagram)

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