Mineralocorticoids are different from glucocorticoids. Why? What is their effect?
They mimic aldosterone and act to aid in renal absorption of Na/H2O and excretion of Ca, Mg, H, and K
Which of the two corticosteroids is wrongly used for shock and skin conditions in small animals?
Dexamethasone
Why is Methylprednisolone an "Atomic bomb" corticosteroid? What does this mean for the patient in regards to effects?
Longer DOA (2-4 weeks) but this mean that effects and side effects will persist for even LONGER.
How do glucocorticoids reduce an immune response? Which immune cells are most suppressed?
By decreasing gamma-interferon, IL-1 and 2 they decrease the activation and recruitment of T cells. This also decreases B cells, macrophage, and neutrophils
The steroidal hormone which gives rise to corticosteroids is Progesterone. What is the main mechanism of action glucocorticoids have at a cellular level that makes them different from other drugs?
Bind to a cytoplasmic steroid receptor and enter the cell nucleus to activate DNA transcription and elicit a biological effect from altered protein synthesis
Corticosteroids mimic the steroids released by the adrenal glands. Name all 10 systems/organs glucocorticoids elicit an effect on.
Liver, Heart, Kidney, Blood vessels, Striated muscle, Fat, CNS/pituitary, Bone, Repro, Immunity
Provide the drug used as a mineralocorticoid in animals with Addison's disease
Fludrocortisone
Hydrocortisone-acetate vs Hydrocortisone aceponate: Whats the diff?!?!
Hydro-acetate is topical and can be licked off, whereas hydro-aceponate is topical but absorbs into skin. Both symptomatic relief
How are glucocorticoids used to reverse ketosis in cattle?
With glucose it increases blood glucose levels by inhibiting the action of insulin, catecholamine-driven glycogenolysis in muscle and gluconeogenesis in liver
What is the law of corneal ulcers?
NEVER GIVE A CORTICOSTEROID IN THE PRESENCE OF A CORNEAL ULCER. Collagenase from bacteria increases, slows epithelial regeneration, will melt the eye
What are the common routes of administration for corticosteroids? Why would you not use ONE of the routes?
PO (tablet or liquid), IM or IA injection, topical. No IV b/c insoluble esters have slow absorption & anti-inflammatory effects with HPAA suppression
Late side effects of corticosteroids include:
Cushings disease (HYPERadrenocorticism), Central obesity/pendulous abdomen, Hair loss
What are the ONLY 2 instances you ever use corticosteroids for shock?
Anaphylactic shock (gluco) & Addisonian shock (mineralocorticoid)
Early side effects of corticosteroids include:
Polyuria (ADH inhibition), Polyphagia (weight change, water retention), Polydipsia (ADH inhibition)
What would be the clinical classification of the following skin lesions?
Chronic Atopy; Atopic dermatitis
Two atomic bombs for corticosteroids are: ________ & _________. Hint: -olone
Triamcinolone & Methylprednisolone
What can a rapid withdrawal of corticosteroids cause? (I want a clinical term)
Hypoadrenocortical crisis
Do cats need stronger or weaker doses of glucocorticoids? Why?
Stronger! They have fewer glucocorticoid receptors than dogs and need more for a clinical response
Corticosteroids act as anti-inflammatories. What is one of the side effects from this action and where does it stem from?
COX inhibition causing stomach ulcers, hypertension, and kidney failure
What are the inflammatory or immune mediators that Phospholipase gives rise to normally?
Thromboxane, Prostaglandin, Leukotrienes
How do glucocorticoids contribute to laminits?
Thought to potentiate vasoconstriction and hyperglycaemia, as well as free radical oxygen which cause tissue damage
The Frontline of corticosteroids are two main drugs. What are they?
Prednisolone & Dexamethasone
How do glucocorticoids initiate labour?
Mimics foetal cortisol and initiates PGF2a to begin uterine contraction and cervical dilation
What is the law of NSAIDs?
NEVER GIVE CORTICOSTEROIDS WITH NSAIDS!!!! Synergistic...except if topical CSt with systemic NSAID...and if a horse cuz fuck why not