Week 2: Meds for Inflammation

3 meds that are antiinflammatory

NSAIDS, Aspirin, Glucocorticoids

glucocorticoids are also called

corticosteroids

administration of glucocorticoids

depends on use

-topical, oral, inhalation, ophthalmic, nasal, intra articular injections

what things have systemic effects

oral, IV

glucocorticoid meds end in

-one

glucocorticoids produced by

adrenal gland

glucocorticoids functions (4)

promote catabolism of proteins, control glucose metabolism, inhibit inflammatory/immunologic responses, regulate stress

glucocorticoids bind to

intracellular receptors and effects transcription of specific DNA genes

glucocorticoids inihibts

phosphlipase A2 and COX2

phospholipase A2 inhibits release of

arachidonic acid

glucocorticoids decreases production of

prostaglandins, thromboxanes, leukotrienes

antiinflammatory effects of glucocorticoids

inhibits expression of cytokines, inhibits productio of pro-inflammatory substances, reduces circulating proinflammatory cells, reduces leukocytes, reduces vascular permeability

reducing vascular permeability cuts down on

swelling

cytokines function

activate inflammatory cells such as t lymphocytes, fibrobalsts, and natural killer cells

pro inflammatory substances that are inhibited (production of them)

prostaglandins, leukotrienes

pro inflammatory cells that are reduced from circulating

lymphocytes, eosinophils

immunosuppressive effects of glucoocorticoids

inhibits hypersensitivity and allergic reactions

immunosuppression effects of glucocorticoids results in

decreased migration of leukocytes and macrophages to site of foreign tissue/antigen

how do glucocorticoids effect the kidneys

affect their ability to excrete water by enhancing sodium and water resorption and increase BP

how does glucocorticoids affect CNS function

behavior and mood changes

steroid induced leukocytosis causes increase in

erythrocytes, neutrophils (only WBC), platelets

steroid induced leukocytosis causes a decrease in

lymphocytes, eosinophils, monocytes, basophils

what do we tend to see from steroid induced leukocytosis

WBC increase, even though you are immunosuppressed. We dont have the right ones to fight infection tho

glucocorticoids effects on metabolism

stimulates formation of glucose and breakdown of proteins into amino acids

cortisol causes muscle cell to

decrease glucose uptake, increase protein breakdown and make amino acids

cortisol causes fat cells to

decrease glucose uptake, increase fat breakdown and make free fatty acids

free fatty acids and amino acids are used to

make glucose and glycogen within liver

net effect of glucocorticoids effects on metabolism

increased liver glycogen levels, increase fasting blood glucose levels, increase urinary nitrogen output

adverse effects of glucocorticoids

adrenocortical suppression, cushing syndrome, hyperglycemia, muscle wasting, hypertension, breakdown tissues, immunosuppression, behaviroal changes, gi distress, edema,

adrenocortical suppression

negative feedback loop, shuts down bodys own production of cortisol

-withdraw slowly via taper

drug induced cushing syndrome

endocrine disorder from too much steroid

cushing syndrome effects

moon face, trunk obesity, osteoporosis, muscle wasting in extremities

cushing syndrome and adrenocortical suppression both occur in

adrenal gland

hyperglycemia is induced by

type II diabetes/steroid

-monitor their glucose

muscle wasting

weakness and myopathy of proximal muscles, affects fast twitch fibers (IIB)

what counters muscle wasting

exercise and protein intake

hypertension

monitor bp, due to enhanced sodium and water retention

breakdown of tissues

bones (Osteoporosis), skin, tendons

-do WB activity

what is inhibited that causes breakdwon of tissues

genes responsible for collagen production

immonosuppression

educate on cleanness, suppresses early signs of infection

behavioral changes

tell them ints normal

gi distress

nausea/vomitting

edema

cortisone and hydrocortisone have more water retention, through sodium and water reabsorption

cushing syndrome and adrenocortical suppression both occur in

adrenal gland