steroids

cortisol secretion process

hypothalamus secretes corticotropin-releasing hormone (CRH)

anterior pituitary releases adrenocorticotropic hormone (ACTH)

adrenal glands produce cortisol (endogenous glucocorticoid)

indications for oral systemic steroids

inflammatory states

autoimmune disorders (lupus, RA, crohn's)

steroid-deficient states (Addison's, adrenal suppression)

asthma (short term burst therapy)

COPD exacerbation

allergic reactions/anaphylaxis

cancer treatment (nausea/enhanced chemo response)

transplant medicine (prevent rejection)

maturation of fetal lungs

pneumonia-co treatment

contraindications for oral systemic steroids

active serious infection (viral, fungal)

role of corticosteroids

Suppress inflammation and normal immune response = keeps tissue damage as low as possible

what steroids do to glucose

increase serum glucose and decrease glucose uptake into tissue = higher blood sugar

what steriods do to calcium

mobilizes calcium from bones (can get bone issues w/ long term use)

examples of systemic steroids (3)

prednisone (deltasone)

methylprednisolone (medrol)

dexamethasone (decadron)

side effects of steroids

hyperglycemia (can induce diabetes)

weight gain/swelling

psych: depression, mania, euphoria, insomnia, confusion

gastric/intestinal bleeding

infections/delayed wound healing

skin stuff: thin, stretch marks, acne, face flushing

eyes: cataracts, glaucoma

muscular: wasting, myopathy

fat deposits (buff hump)

osteoporosis

cushing's syndrome

what happens when taking steroids and NSAIDS together

big increased risk of GI bleed